NHS should hire 'innovation scouts' to help plug funding gap

The NHS should create specific roles – Directors of Innovation and innovation scouts - that are responsible and held accountable for innovation as part of wider productivity reforms, according to a new report from the think tank IPPR published today. The report shows that ‘innovation scouts’ would help to drive the innovation agenda and increase demand for new processes and products which could help the NHS to meet its efficiency targets.

The NHS will face a funding gap of £Â£30 billion by the end of the next parliament in 2020, as outlined by NHS England. If the NHS is to bridge this gap it needs to achieve £Â£22 billion in increased productivity by 2020, which would mean achieving annual productivity rates of 2 to 3% rather than a continuation of its historical average of 1.5%. The report shows that better use of innovative technologies in the NHS could be part of how services achieve this.

The report shows that innovation is one of the most important things the NHS can do to meet the challenges it faces. In a health service with increased demand and few recourses the NHS must find a whole range of innovative approaches to delivering care in order to build a health service that can give patients the care they want. For example, VitruCare, a health management app delivers a saving for the NHS and GP surgery of around £Â£1.5 million for every 10,000 patients who use it by preventing emergency admissions and assisting patients to make better decisions.

The report identifies a number of significant barriers to innovation in the health service:

• Innovators and potential buyers within the NHS often struggle to locate each other.
• No one is held accountable for innovation and therefore demand for new innovation is suppressed
• The payment mechanism in the NHS often disincentives the uptake of new innovations

To tackle the barriers to innovation and the dual challenges of resource constraint rising and more complex demand, the report recommends that, as well as hiring innovation scouts, the NHS should do a number of things:

• Hire Directors of Innovation and innovation scouts: Innovation scouts would identify areas where innovation is needed, search out best-practice innovations to fill these gaps, and help to bring down barriers to adoption, ideally focusing on specific conditions or areas of care. They would also seek to empower clinicians and commissioners to demand innovation and overcome barriers to innovation themselves.
• NICE should assess all significant new medicines: NICE should take on responsibility for assessing and making procurement recommendations for all significant new drugs, mimicking the role of the Scottish Intercollegiate Guidelines Network (SIGN). This would speed up the adoption of innovative new medicines and ensure more equal access to life saving drugs across the country.
• Care pathways designed with patients: Patients can act as a driver of innovation. Care pathways should be designed through a process of co-production involving patients, clinicians and commissioners and should be designed around patient populations (segmented by specific conditions or frailty).
• Personal health budgets for long-term conditions: A good way of allowing patient led innovation is making them the lead commissioner of their care. This can be achieved through offering all patients with a long-term condition the right to a combined personal health budget if they want one.
• A longer commissioning cycle: The NHS should move from a one-year commissioning cycle to a three-or even five year cycle - allowing CCGs to plan capital spending and invest in innovations. This could also be achieve by relaxing the requirement of CCG’s to balance their books in cases where a deficit is caused by capital investment which will induce savings later.
• Providers should be paid based on co-produced outcomes: Providers in the health service should be integrated and jointly held to account on the delivery of care pathways – with payment tied to a set of coproduced outcomes. By the end of the next parliament services for those with complex needs should be jointly commissioned by the local authority and the CCG through the local health and wellbeing board, using a pooled budget.
• Academic Health Science Networks (AHSNs) should take a lead role as ‘market makers’ in the NHS. As well as promoting innovation scouts across the NHS, they should help to overcome the complexity of the system, working together as a network to direct innovators towards potential buyers within the NHS, as well as identifying ‘innovation gaps’ in their local health economy and locating potential innovations to fill them.

Harry Quilter-Pinner, IPPR Researcher, said:

“We are facing a funding crisis in our NHS. One of the ways we must look to tackle this is by increasing the productivity of the service through the use of innovative technologies and innovative ways of delivering care.

“Not only would this mean a more effective and efficient health service but it would also give the service the flexibility to give patients the care they want – allowing them to have more control over their own care, as well as access to cutting edge technology.”

“In order for us to achieve meaningful and lasting innovation in the NHS we must demand innovation rather than waiting for it to occur. One way to ensure that this occurs is to create ‘innovation scouts’ across the health service whose job it is to seek out new innovations and embed them in the NHS.”

The report also highlights best practice in innovation from both public and private sectors including Princess Alexandra Hospital in Harlow, which has a Director of Innovation, and companies such as Proctor and Gamble that use innovation eco-systems across their entire company.

Notes to Editors

IPPR’s new report Improved circulation: Unleashing innovation across the NHS will be available on Thursday 4 June from: http://www.ippr.org/publications/improved-circulation-unleashing-innovation-across-the-nhs

INNOVATION CASE STUDY: VitruCare, Health Management App and Platform

VitruCare delivers a saving for the NHS and the GP surgery of around £Â£1.5 million for every 10,000 patients who use it by preventing emergency admissions and assisting patients to make better decisions. Indeed, we estimate that if this was used across all patients with chronic conditions, the average GP surgery would require one less doctor.

VitruCare is a cloud-based health management platform, integrated with SystmOne, which enables patients to book practice appointments and local services, order repeat prescriptions and see their electronic healthcare records. Patients can manage wellness, prevent disease, and manage long-term conditions and the last days of life using VitruCare. Care is personalised depending on individual requirements. They can set their own goals, actions plans and trackers to take control of their care and discuss these with their clinician.

VitruCare has been adopted in Bradford, Cumbria, and North Yorkshire but is yet to be spread across the country.

INNOVATION CASE STUDY: Intraoperative radiation therapy, Princess Alexandra Hospital, Harlow

Traditionally, radiotherapy is undertaken, five days a week for five or six weeks, after the cancerous cells have been surgically removed. This is usually undertaken in specialised hospitals which are spread across the country. Intraoperative radiation therapy delivers a concentrated dose of radiation therapy to a tumour bed during the surgery which occurs at the patients’ local hospital. This saves the patient time, stress and money. Just as importantly, it preserves more healthy tissue and reduces the side effects of the treatment. Furthermore, from the NHS’s point of view it saves a significant amount of money in terms of equipment and practitioner’s time.

“This product required a huge upfront investment – for the machine which conducts the radiotherapy – however the long term gains for the NHS are significant. The problem is persuading the CCG or hospital trust to make that initial investment.” Director of Innovation, Princess Alexandra Hospital, Harlow

The report shows that the Department of Health itself acknowledges the need for better spread of innovation across the health service. They said: “Whilst we are good at inventing and developing new technologies the spread of those inventions within the NHS has often been too slow, and sometimes even the best of them fail to achieve widespread use.” (Innovation, Health and Wealth, 2011)

Contacts

Sofie Jenkinson, 07981 023 031, s.jenkinson@ippr.org

Richard Darlington, 07525 481 602, r.darlington@ippr.org