Innovation for higher quality and lower costs

At no other time in its history has the NHS needed innovation for service delivery as badly as it does now. Without innovation, the pressure to contain costs will only be met by cutting services or forcing overstretched staff to work even harder. 

BUT, innovation won’t just happen, even if we give it a high strategic priority. There is one consistent message from innovative organisations globally.

Innovation is a structured and disciplined process. We are unlikely to achieve the breakthroughs we seek in quality and cost unless we “operationalise” innovation, building it into all aspects of our daily work. We have a highly creative NHS workforce, but too often that gets repressed.  As David Nicholson describes it in his recent NHS Annual Report, the mindset is “we want to improve, but innovation is risky and failure will be punished”. Key tasks for NHS leaders in the next period include settingthe tone and creating the conditions where innovation can flourish and investing in systems and skills for innovation. Innovation practice must become part of the very DNA of the NHS.

That’s why we launched the pilot “Innovation Practitioner Programme” at the NHS Institute this week to build NHS innovation for improvement capability. It’s a small start with 20 people taking part from across the NHS - providers and commissioners, from clinical, operational and improvement leadership roles.  Our view is the people who will make the most impact as innovation practitioners are those who already have a strong track record of delivering improvement. Innovation and improvement skills go together, yet few NHS improvement leaders have formal training in innovation processes.

Our 20 Innovation Practitioners took part in the first two days of an intensive training programme. They have been coached in models and frameworks for developing a culture of innovation and observation and insight skills. They have followed a systematic process for innovation, including ideas generation, prioritising and selecting ideas, prototyping (how to avoid costly mistakes by quickly assessing whether an idea is likely to work) and creative implementation. The entire process has been underpinned by a philosophy of “open innovation”, which means an approach to innovation that is not constrained by internal thinking, but that casts the net widely for new ideas from other organisations and systems. You can access some of the material that the Innovation Practitioners have been using by clicking here.

All of the participants will  take an online examination in innovation practice methods later this month.

Innovation practice methods are only useful if they help to deliver better results for patients and populations. Therefore, each of the participants is undertaking a significant project to apply innovation practice in their own setting. Through the projects, the Innovation Practitioners are “thinking differently” about pre-hospital emergency care, orthopaedic services review, paediatric high-dependency care and patient discharge communication. They will be coached by our innovation practice experts as they implement their projects over the next six months. The Innovation Practitioners who pass the exam and are able to demonstrate use of the range of innovation methods and tangible outcomes in quality and cost will be accredited by the NHS Institute as NHS Innovation Practitioners.

This may seem like a tough process, yet let’s compare it to the learning process of clinical practitioners. Can you imagine a situation where someone with no formal clinical training or experience was allowed to practice unsupervised on patients? Yet that is the equivalent scenario that most people who are asked to lead innovation practice in the NHS face. They are expected to just work it out for themselves, or learn it on the job. We need to move to a situation where innovation and improvement practice is as well taught and supported as clinical practice. I would want you to be confident that any Innovation Practitioner was highly capable and experienced and could make a big difference very quickly.

Innovation practice is a key skill for NHS change agents to deliver quality improvement and cost reduction. Our team within the NHS Institute has been undertaking exploratory work to define the wider set of skills (including innovation practice) that we need to invest in to deliver the goals of the Next Stage Review and save costs at the same time. I will post my next blog on 13 July about this topic.

There are a number of areas that, as an NHS system, we need to invest seriously in, in order to save costs. Innovation practice for improvement comes pretty high up my list. We need to think about how we make this happen on an industrial scale, from 20 accredited NHS Innovation Practitioners to hundreds to thousands.