Specialist hospitals leading the way in innovation

At a time when the NHS is under the financial cosh, it is easy to forget that innovation is part of the solution not the problem. With that in mind, the Federation of Specialist Hospitals has just published a new report Driving Innovation in the NHS, which sets out the role members play in driving forward clinical innovation while sharing best practice to improve efficiency and outcomes through the development of new care models.

In his foreword to the report, Simon Stevens recognises the need to “maximise the impact of these centres of excellence and spread their learning across the rest of the health service.” The report’s recommendations aim to help make that a reality and enhance the NHS’s reputation as a global leader of innovation in the process.

Bridging the innovation gap

It is commonly recognised that research and innovation are key to addressing the challenges facing the NHS. Nevertheless, there remains a significant gap between our capacity to innovate and our ability to turn these innovations into real benefits for patients.

Specialist hospitals have a proud record for firsts, from eye surgery under local anaesthetic in the nineteenth century to the pioneering use of artificial hearts in recent years. As world-leading centres of excellence, they are a recognised route for clinical innovations to enter the NHS.

’Specialist hospitals have a proud record for firsts’

A rich array of practical case studies in our report illustrate the initiatives led by specialist hospitals to translate innovation into patient benefit while delivering savings.

Examples include:

The Getting It Right First Time review of adult elective orthopaedic services, driven through the Royal National Orthopaedic Hospital, to address variations in practice and drive efficiency and improved quality and outcomes in the delivery of orthopaedic care. I am pleased to say that this programme is now being rolled out to a wide range of other specialties as part of Lord Carter’s procurement programme.

A trial conducted at Liverpool Heart and Chest Hospital which found that the routine use of heparin rather than bivalirudin can improve outcomes for heart attack patients, while realising cost savings amounting to hundreds of millions of dollars globally.

The Royal Brompton and Harefield has developed a unique, web-based Hospital to Home pathway to support children who require long-term ventilation to be safely discharged from hospital, halving the time in hospital for children who need a ventilator to breathe.

In this context, Federation members welcome the work of the Accelerated Access Review and are pleased to contribute to the review through this new report. But as Rob Webster of the NHS Confederation recognises: “the ultimate test for the review will be how effectively the health system is able to adopt and spread innovations like these for the benefit of our staff, our patients and the NHS.”

Developing new care models

The NHS Five Year Forward View also endorses specialist care networks as a powerful mechanism for spreading best practice and supporting the clinical and financial success of more local hospitals.

Specialist hospitals have led the establishment of these networks to deliver local services to patients with specialist oversight. In doing so, specialist hospitals are able to contribute to the educational and staffing needs of local hospitals, whilst helping more local trusts keep pace with the latest technological advancements in treatments.

Specialist care networks highlighted by the Federation’s report include:

The Walton Centre and its partners have established the Cheshire and Merseyside Rehabilitation Network to care for patients in services appropriate for the complexity of their needs, leading to shorter lengths of stay across the network and a 69 per cent reduction in cost compared to the previous pathway.

Moorfields Eye Hospital delivers a range of specialist and routine ophthalmology services across 23 sites in and around London. Approximately 50 per cent of Moorfields’ total activity is delivered away from its central London hospital.

The innovations can make a significant contribution to meeting the NHS’s financial challenge

The Christie has introduced a quality mark and regular site inspections to maintain high quality care across its network. Clatterbridge Cancer Centre has established a wholly-owned subsidiary company to supply medicines for home administration, strengthening clinical governance and enabling savings to be kept within the NHS.

We are pleased to see these trusts and other Federation members recognised by the latest wave of new care model vanguards, described by the NHS England press release as “some of the best known and best run hospitals in Britain”.

The work that is being done by the vanguards presents a welcome opportunity to explore the system and commissioning levers to support new models of care. For specialist care networks in particular, there needs to be a focus on new payment approaches that incentivise quality and efficient care delivered in the right settings.

The sooner the NHS can move away from the current outmoded tariff system, which rewards activity wherever it is undertaken, to payment methods which support integration and true quality outcomes the better. This will mean centralisation of some specialised services in order to achieve the best outcomes for patients as well as best value for the taxpayer.

Federation members are committed to work with others throughout the NHS to building on the successes of these networks and enhancing the NHS’s reputation as a global leader of innovation. It is equally important that policymakers and commissioners work with specialist hospitals to roll out these local innovations which can then make a significant contribution to meeting the NHS’s financial challenge.

Professor Tim Briggs is chair of the Federation of Specialist Hospitals and the national director of Clinical Quality and Efficiency at the Department of Health