From working over 10 years in NHS operational roles, I’ve seen first-hand the incredible innovation that happens every day in numerous providers and systems. A case in point being the astonishing innovation and creativity shown during the pandemic – unarguably the NHS’ biggest and most enduring test since it was founded in 1948. But what is the current state of innovation across the NHS, and perhaps more importantly, what does it mean for tomorrow’s healthcare?
To properly understand innovation in the NHS, and to see how it might be improved, we can look back and see the innovation journey the NHS has been on over the last decade or so.
I joined the NHS Institute of Innovation and Improvement as a graduate management trainee in 2009. Its remit was to transform healthcare with new ways of working, new technology, and great leadership. This was at the tail end of the significant annual budget increases the NHS received, and when there was more money for innovation. But after the 2008 global financial crash, and the need to balance the nation’s books, the annual NHS uplift was reduced to 1%. In real terms, when accounting for inflation, this was a drop and over subsequent years the fiscal challenge became tougher and tougher. Required to do more with less, the money for innovation inevitably became scarcer.
However, despite this economic backdrop, there have been various attempts to kick-start innovation at a national level, not least through the NHSX programme (now part of the NHS Transformative Directorate). But the general trend felt to be declining investment in long range innovation and greater focus on innovation for in-year cost improvement. As such, projects that did secure funding needed to guarantee return on investment and demonstrate quick results. And you can understand why when you look at the difficult choices many providers and systems have to make.
A matter of priorities
It’s about priorities and how you perceive innovation. Should you focus on solving issues in the here and now? Or should you focus on creating tomorrow’s healthcare systems, but with the added risk of failure? Or put another way, do you invest taxpayer money on a project with a 50% chance of transformational success in 3-5 years’ time? Or do you invest in recruiting and retaining more nurses on wards to maintain and provide the best quality patient care today? Looked at through that lens, any kind of transformative innovation feels like an unjustifiable luxury, and even more so during a pandemic.
Understandably, most innovation focus in the NHS goes into solving today’s problems, rather than looking to the future. The criticality of providing day-to-day healthcare leaves little headspace to think about the medium or long-term.
Innovation is happening
And yet, against this backdrop, outstanding innovation continues in pockets of the NHS. For example, Chelsea & Westminster Hospital Foundation Trust’s CW+ innovation programme is leading the way in various fields – from patient-centred care to using AI and machine learning to improve care outcomes. The funding model for this is predominantly via the charity sector, which provides ring-fenced funds to invest in research, equipment, and innovation projects which are often supported by commercial partnerships.
At BCN (and our subsidiary Cloud2), we build on the Microsoft platform with our healthcare customers to innovate and deliver solutions that make a difference. This includes developing an easy-to-use Statistical Process Control (SPC) application that’s baked into Power BI. In doing so, we’ve helped the East London Foundation Trust (ELFT) save the equivalent of 19 staff working days (141 hours) every single day. We’ve also worked with the Northern Care Alliance to create a game-changing Bed Complement Manager application.
We’re pushing Power BI to its limits for another NHS customer, so they can create automated board, divisional, and specialty performance reports very simply and quickly. The reports includes benchmarking, a managed commentary process and action tracking that creates clear, auditable governance. One of the ways we’ve achieved these co-investment innovations and returned value to the NHS is by reselling the solutions created to other sectors and countries. For example, we’ve seen the SPC application downloaded by over 21,000 organisations in 116 countries. In fact, we believe the automated performance reports could equally benefit any organisation that requires strong governance controls and an at-a-glance view of a range of indicators.
My other role at BCN is leading Public View, a performance monitoring and benchmarking service I founded in 2018. More recently, Public View has been developing an ICS (Integrated Care System) version with Cheshire and Merseyside ICS that goes beyond acute care. This version brings together mental health, community, ambulance, and primary care data to provide complete healthcare coverage in a specific ICS and place. We’re also working on a view of private healthcare providers in a bespoke product for another customer and expanding to other industries.
So, what do the next few years of innovation look like for the NHS? Well, with little head space or financial resources to ringfence for innovation, options are limited. But one way NHS providers and systems could continue to plan and innovate for the future is through partnerships that can enable a return on investment via commercial exporting to different sectors and countries. These partnerships can create a springboard for innovation through co-investment funding models that minimise the risk to bring innovations to market.
Innovation is a necessity in all organisations, but especially so in healthcare. However, under a traditional funding model it’s an unjustifiable luxury for many in the context of today’s healthcare priorities. Partnerships with organisations like BCN can enable important innovation to remain at the heart of the NHS, today and in the future.