The NHS is at a critical juncture, facing both significant challenges and tremendous opportunities through innovation. That's according to The Innovation Ecosystem Programme which has outlined how the UK can lead the way globally in health gains and life sciences powered growth.
On the one hand, the NHS is grappling with workforce capacity, inefficiencies and widening health inequalities that have a substantial impact on individuals and the nation’s health. These challenges are exacerbated by rising demand for care, an ageing population and stretched resources.
On the other hand, the NHS and its partners – in the patient and charity sector, regulation, industry and universities – have an incredible record of developing life-saving treatments and innovative technologies and setting benchmarks for high quality patient care. They give the UK an unparalleled potential to be the world leader in the testing and adoption of healthcare innovation. The NHS’s scale, deep integration with the UK’s thriving life sciences sector and access to rich health data puts it in a unique position to drive advances in medical technologies. This will deliver transformative patient outcomes and economic impact for the UK. However, to seize the opportunities that come through innovation, NHS England and its partners must be decisive. We need to galvanise action at all levels – national, regional, integrated care system (ICS) and neighbourhood – to overcome the challenges the NHS faces today. Our aim is to unlock the NHS’s full potential to improve patient outcomes through innovation and enhance the nation’s health and economy for the future.
The Innovation Ecosystem Programme was given a mandate to foster collaboration between the NHS and key stakeholders
The Chief Executive of NHS England commissioned the IEP with a mandate to foster collaboration between the NHS and key stakeholders, industry, academia and regulatory bodies. The objective was to streamline the development and adoption of healthcare innovations by making recommendations but also defining a collaborative way of working – solving problems together as well as agreeing and delivering plans for the future.
The subsequent recommendations stem from analysis of extensive engagement – hundreds of interviews, roundtables and working group discussions – through 4 targeted workstreams led by the chief executives and chairs of many of the key organisations in the life sciences ecosystem.
Findings: Progress is being held back by poor alignment, culture barriers, process and capabilities
Throughout the programme a clear set of 5 emerging findings have consistently emerged from our discussions, roundtables and analysis of the current ecosystem.
There is a solid foundation to build on, but we must expand and translate what we do well. The NHS has many strengths in innovation, in early-stage research and development, real world testing and initial site adoption, and in some cases, such as cancer and genomics, the delivery of flagship national innovation programmes. We already have the ingredients to enable transformation and there is no shortage of innovations being explored in the NHS, as well as in partnership with industry. We also found that stakeholders have a clear, common understanding of what it takes to successfully adopt innovations. We can and must build on the pockets of excellence that already apply this understanding to scale current innovation. But we also need to go further by looking to the future and understanding how emerging technologies give us the tools for a faster shift to prevention, early diagnosis and out of hospital care. New skills and experience in new settings will be required.
We must focus on the biggest priorities. The scale of the challenge to transform our services should not be underestimated, and we will need to make choices about where our scarce resources are directed. The NHS and its partners will need to be less ‘supply side’ in how they identify innovation, instead prioritising innovation and research support for areas of greatest need, aligned to the government’s health and economic growth missions. We will need to move away from the historical focus on individual products to categories of innovation and shifts in care, and from looking at a 1 to 2-year horizon for innovation and research to planning for 3, 5 and 10 years ahead.
The NHS cannot do this alone or from the top down. We need better alignment of innovation and research infrastructure – orientated towards the local and with easier gateways for partners to engage with the NHS. We need clarity on who is responsible for what and when to enable simplified, streamlined access for both testing new things and rolling out. And this infrastructure should be aligned to national ambitions and be supported by national levers. However, national implementation policy should not be so prescriptive that it stifles the mobilisation of collaborative local systems.
Success will come down to getting the culture right, building a skilled workforce and putting the right enablers in place. Innovation only succeeds when it can be effectively adopted locally, and this needs individuals who can drive through implementation in a supportive culture. For the right culture, patient and citizen voice, NHS management and clinical leadership, and strong industry support will be key in sending the signal that innovation and research are important. For effective leadership, enablers will need to be in place to better empower NHS staff on the ground to participate in research and adopt innovation: data, procurement processes, and the time and incentives. We also need to make it easier to adopt innovation by reducing friction in the system with a clear, consistent, standardised and streamlined rules-based approach, and standardise how industry, academia, charities and patients can partner with the NHS.
This will take time, and we will need to be consistent and long term in our approach. The NHS has suffered from a series of short-term projects and approaches (despite the same barriers and enablers being identified over the last 20 years). Success in implementing the recommendations of the IEP will require collective accountability and resourcing for 3 to 10 years, with a clear strategy that all partners are signed up to and eager to support.
Date: 2 December