The Innovation Ecosystem Programme (IEP), founded in 2023 with the aim of discovering how best to streamline development and adoption of innovations in the NHS, last week published its inaugural report.

The report was  based on interviews and working group discussions with NHS workers, industry participants, academics and other stakeholders conducted over the past 18 months. 

It summarises the IEP’s findings and presents a suite of recommended actions with the aim that it will contribute to the 10-Year Health Plan, the Innovation and Adoption Strategy and the Life Sciences Sector Plan. 

Key Takeaways 

• The report places a heavy emphasis on the importance of prioritisation in the NHS’s approach to adopting innovation. Scarce resources will need to be carefully directed and aligned to the government’s health and economic growth missions. 
• There is an awareness that a culture shift will be required in order for recommendations to be effectively implemented. Collaboration is vital, both internally in the NHS and externally, between the NHS and critical partners in industry and academia. NHS staff need to have innovation built into their roles and be allowed dedicated time for innovation activities. 
• This collaboration and alignment of innovation and research infrastructure needs to occur at the local level, by mobilising local systems. Robust governance structures should be employed to facilitate confident local decision making and effective cooperation with external stakeholders. A top-down approach to innovation will not succeed. 
• A shift towards a long-term approach to design and implementation is needed if the real benefits of innovation are to be felt. Plans need to be made looking 3, 5 and 10 years into the future, rather than simply addressing short term needs on the 1-2 year horizon. 
• Overall, there is a sense among stakeholders surveyed that the UK is well placed to be the world leader in healthcare innovation and stands to benefit both economically and in terms of patient care from committing to embedding innovation in our healthcare system. 

Context: Why is this report needed?

One of the IEP’s key findings was a strong sense of optimism among stakeholders that the UK is well positioned to be a global leader in healthcare innovation. The NHS and UK life sciences companies have an impressive history of pioneering research and development which offers a solid foundation from which to launch further efforts in innovation. 

Nevertheless, the report comes at what it describes as a “pivotal moment of risk and opportunity” for the NHS. With an ageing population and significant health inequalities putting pressure on both the NHS’s workforce and its finances, most staff feel that they have neither the capacity nor the support to effectively engage with innovation. A risk averse culture and inconsistent and unclear policies also present challenges. The prevailing issues hindering healthcare innovation are therefore occurring predominantly at the adoption and scaling stages, not with research and design. 

There was an indication that industry and academic institutions can find it difficult to establish effective partnerships with NHS providers, so that we are beginning to see companies planning to launch medical devices in alternative jurisdictions as a result. 

The report identifies early detection, diagnosis and prevention, and the personalisation of medicine and therapy as primary concerns.  Additionally, innovations could change the workforce by facilitation of processing, manual tasks and supported decision making by AI.

What does the report recommend? 

The IEP’s recommendations are intended to work synergistically and focus primarily on alignment between stakeholders across the NHS, industry and academia. While some areas identified by the IEP are already in the process of being addressed, other recommendations will need significant further development before they can be implemented.

The recommendations are summarised below, grouped under four key headings. 

Setting direction: The innovation ecosystem needs to align with the government’s health and economic goals, specifically focussing on hospital to community, analogue to digital and sickness to prevention. The focus must move away from the traditional emphasis on individual products and be based on an awareness of what the NHS will need within a 10-year horizon.

1. Make innovation core to NHS business.
2. Prioritise and co-ordinate innovation around goals for health. This includes aligning activities and funding across the NHS, regulatory bodies, charities and government research infrastructure and committing to funding and delivery plans over a multi-year period.
3. Establish co-ordinated oversight and aligned innovation funding to fund fewer but larger pools of money. Specifically, funding models should be developed which allow charities and industry to participate. Wherever possible innovation budgets should be aligned across the following organisations and should be flexible and long-term, spanning multiple spending reviews:
   1. NHS England
   2. National Institute for Health and Care Research (NIHR)
   3. The Department of Health and Social Care (DHSC)
   4. UK Research and Innovation (UKRI)
   5. Innovate UK 
   6. Local NHS organisations 
4. Develop incentives and monitor delivery using KPIs for the testing and adoption of innovation.

Structures and tools for delivery: A robust set of standard tools, policies and guidance must be implemented at all levels to support decision-making at the local level. By streamlining overcomplicated oversight structures, space can be created for innovation programmes to flourish at the local level whilst supporting consistency. Clearer policies on data sharing and intellectual property will enable improved collaboration across the NHS and external stakeholders.

1. Simplify and strengthen the structures and functions for innovation in the NHS. Encourage communication between regions via health innovation networks (HINs).
2. Strengthen data access and information governance. Require all providers to publish standard care data into a shared record, which all researchers can access in accordance with information governance safeguards. 
3. Align procurement to facilitate rollout of innovations post testing. 
   1. Leverage recent proposals for the Integrated Rules Based Pathway (IRBP) for MedTech to establish rules-based access pathways for the procurement of effective healthcare technologies. 
   2. Develop an equivalent of the Treasury ‘Green Book’ for NHS England for business cases for innovation. 
   3. Implement a national passporting system of elements of innovation testing and adoption within NHS England. 
4. Develop commercial approaches to share value in testing of innovation by refreshing national IP policy. 

People, skills and capabilities: Training and recruitment needs to change to reflect innovation as a core competency within the NHS workforce. The means providing staff with the right skills, capabilities and culture to support collaboration but also building dedicated time into roles to support the testing, adoption and scaling of innovation.

1. Build the right skills and capabilities among NHS staff around innovation adoption, evaluation, risk management, change management and working with external partners. Work with industry, universities and Royal Colleges to do so. 
2. Create time in jobs for innovation. Integrate innovation into existing roles, ensuring time is set aside for this function and establish joint clinical fellowships with industry.
3. Foster culture and understanding by visibly championing innovation testing and adoption and actively identifying 200-300 ‘innovation leaders’. Offer education opportunities and secondments to NHS researchers and staff at every career stage.  

Acceleration: The IEP recommends working at the local scale in the first instance, prioritising those areas which have already proven themselves as centres of excellence in innovation development and adoption. By doing so, flexibility at the local level will be built into the innovation ecosystem, and major localities can step forward as leaders in support of national priorities and facilitate sharing learning throughout the system.

1. Mobilise local systems behind work, using major localities to drive innovation in nationally designated priority areas. 
2. Evaluate what works by planning for comprehensive evaluation practices, aligned with NICE assessments, from the outset of new investments in innovation. 
3. Establish peer learning networks to spread best practice and build up a support system. 

If you would like to discuss any of the above please contact a member of our Healthcare team. This article was written by Sophie Pace-Bonello.