CLAHRC NDL BRIEF: Innovation Health and Wealth Accelerating adoption and diffusion in the NHS
CLAHRC NDL prepares briefings on pertinent Health and Social Care documents and policy for ease of reference. However, there may be omissions (perceived or actual) in the briefing: a link to the full document is therefore provided.
1. Published on 5 December 2011, the document sets out an integrated set of measures that together will support the adoption and diffusion of innovation across the NHS, and sets out a delivery agenda which will significantly speed up the pace and scale of change and innovation. The full DH document (36 pages) can be found at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndG uidance/DH_131299
2. The report has been developed as part of the Prime Minister’s UK Strategy for Health Innovation and Life Sciences. The aim of this strategy is to ensure that the UK maintains and builds on its world leading position for life sciences, and that the UK remains and grows as an attractive location for investment now and in the future. The document has been brought together by the NHS Chief Executive Review Team supported by an External Advisory Group and underpinned by over 300 responses to the call for evidence from clinicians, academia, industry and a wide range of other stakeholders.
3. All parts of the NHS will need to take bold, long term measures in 2012/13 to secure sustainable change. The role of innovation will be critical to this.
4. The document contains short briefings on innovation, why it’s important, barriers to innovation and diffusion and what makes diffusion happen successfully. (See section 7)
5. The document’s key focus on is eight priority areas for improvement (section 8) and descriptions of High Impact Innovations (section 9) which should be introduced with immediate effect.
6. Chief Executives and senior leaders in all areas of the NHS are now expected to make an immediate start by Building the actions set out in this document into their planning processes for 2012/13 Planning to deliver the High Impact Innovations Working together to develop local plans for the formation of Academic Health Science Networks.
Key messages include:
7. Innovation is defined as ‘an idea, service or product, new to the NHS or applied in a way that is new to the NHS, which significantly improves the quality of health and care wherever it is applied’ 7.1 Copying is good. 7.2 Innovation transforms patient outcomes Innovation can simultaneously improve quality and productivity Innovation is good for economic growth 7.3 Barriers to diffusion are well documented; the focus of the report is on developing solutions to those barriers 7.4 What makes diffusion happen? Top down pressures (central requirements, regulation and incentives with support), horizontal pressures (peer influence, collaboration and competition) and bottom up pressures (patient and public demand, professional and managerial enthusiasm, entrepreneurship and choice)
8. The priority areas for improvement:
8.1 Reduce variation in the NHS and ensure greater compliance with NICE guidance. Introduce a NICE compliance regime to reduce variation All NICE technology appraisal recommendations are incorporated automatically into relevant local NHS formularies Establish a NICE implementation collaboration to support prompt implementation of NICE advice
8.2 Working with industry, develop and publicise better innovation uptake metrics. Develop and publish an innovation scorecard to track compliance with NICE technology appraisals. Procure a single comprehensive and publicly available web portal for innovation in the NHS. Work with Which? to develop consumer campaigns to raise awareness amongst the public and patients of innovations in healthcare. Establish the clinical practice research datalink – a new secure data service within the medicines and healthcare products regulatory agency.
8.3 Establish a systematic delivery mechanism for diffusion and collaboration, building strong cross boundary networks. A national knowledge exchange network will be developed by applying the Academic Health Sciences Centres (AHSC) partnership model to align education, clinical research, informatics, innovation, training & education and healthcare delivery to improve patient and population outcomes. Academic Health Science Networks, to be formed in 2012/13, will work closely with other parts of the innovation landscape including NIHR Biomedical unit and Centres (BRUs and BRCs), NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRCs), Health Innovation and Education Clusters (HIECs) and NHS Innovation Hubs. At the same time, a sunset review of all NHS/DH funded or sponsored bodies will be undertaken to make recommendations about future funding.
8.4 Align organisational and personal incentives and investment to reward and encourage innovation. Align financial, operational and performance incentives to support the adoption and diffusion of innovation. Increase the profile of, and maintain investment in the NHS innovation challenge prizes. Extend the ‘never events’ regime and encourage disinvestment in activities that no longer add value. Establish a specialised services commissioning innovation fund
8.5 Improve procurement arrangements to make the NHS a better place to do business. A procurement strategy will be published in March 2012. Aim to double investment in small business research initiative to develop innovative solutions to healthcare challenges and help drive growth in the UK SME sector. The NHS Intellectual Property strategy will be reviewed and a model developed for contracts that is fit for purpose
8.6 Develop staff by ‘hard wiring’ innovation into training and education. Build innovation much more clearly into competency frameworks. Establish joint industry and NHS training and education programmes for senior managers. Establish an NHS Innovation Fellowship scheme
8.7 Strengthen leadership in innovation The NHS Operating Framework for 2012 – 13 requires the NHS to prioritise the adoption and spread of effective innovation and good practice. Clinical commissioning groups will be under a duty to seek out and adopt best practice and promote innovation. Strengthen leadership and accountability for innovation at board level throughout the NHS
8.8 Identify and mandate the adoption of high impact innovations. (From April 2013 compliance with these high impact innovations will become a pre-qualification requirement for CQUIN) Accelerate the use of assistive technologies in the NHS aiming to improve at least 3 million lives over the next five years. Launch a national drive to get full implementation of Oesophageal Doppler Monitoring (ODM) or similar fluid management monitoring technology into practice across the NHS. Launch a ‘child in a chair in a day’ programme to transform the delivery of wheelchair services throughout the NHS. NHS organisations will be required to explore opportunities to increase national and international healthcare activity and DH will host a summit with UK trade and investment in the New Year. The NHS will be required to work towards reducing inappropriate face to face contacts and switch to higher quality, more convenient, lower cost alternatives. The NHS will be required to commission services in line with NICE – SCIE guidance on supporting people with dementia.
The new commissioning system presents an opportunity to de-clutter, consolidate and streamline innovation activity in the NHS.
A new implementation board to oversee delivery is being established with Sir Ian Carruthers as the chair, reporting to the NHS Chief Executive.
Liz Lesquereux 7 December 2011
The NIHR CLAHRC – NDL is a partnership between the University of Nottingham and local NHS organisations and is funded by the NIHR.