How to achieve the cultural change required to drive NHS innovation

The NHS is in need of innovation and change. Too much of the service is out of date, inefficient and failing to meet the expectations of patients. Our ageing population, evolving disease burden and economic challenges are being exacerbated by the profound and pervasive technical, social and cultural changes which are rapidly altering expectations and demands of healthcare provision.  

The public has come to expect consistently high levels of service, choice, transparency and true customer-focus - expectations which have exposed  parts of the NHS stuck in attitudes, behaviours and cultures little changed from 1948. This should not, however, be seen as reason for despair, but as an opportunity for change.

Unfortunately, while it is easy to say that the NHS needs to embrace innovation, it is far harder to find examples where this has proved effective. Accepting a real risk of failure is an absolute prerequisite for innovation - if you are not prepared to fail, then you are unable to innovate.

How, then, do you innovate in the NHS? How do you risk failure without sacrificing quality and safety? The answer to these questions can be found. Real innovations in healthcare have emerged from small groups determined to improve patient care through ideas, creativity and energy.

Healthcare innovation in other countries

Estonia created a national eHealth solution in less than six years, and for less than seven million euros. The public and private sector worked together to deliver online health records, electronic appointment booking and e-prescriptions for the whole country.

US open-data for health is one of the world’s most innovative healthcare projects. By making available huge swathes of previously hidden healthcare data, the programme has already enabled what seems to elude the NHS: self-financing businesses that directly support patients and improve healthcare.

The Open School was created by the US charity, the Institute of Healthcare Improvement. It delivers support, training and education in safety and quality for healthcare professionals across the world. Its huge success and rapid expansion on a tiny budget has been made possible by positioning social and online media as the primary channel of communication with its users.

The Mayo Clinic, originating in the US, uses social media and networks to recruit patients with rare diseases into clinical trials, reducing time, money and effort for vital research.

Learning lessons from the private sector

The above examples are all healthcare-based, but the NHS must look further for innovation. A whole range of industries and other sectors - both public and private - demonstrate what can be achieved when organisations think differently.

How is it that the availability of every “Boris-bike” across London can be checked instantly from any smart-phone, yet it is impossible to check the waiting time for your local A&E department?   

By investing in technology and utilising crowd-sourcing, the NHS could improve communication and tap into its vast workforce as a self-monitoring source of information.

Future of innovation - what should the NHS be doing?

• Everybody working in, for, and with the NHS needs to think far more broadly about the opportunities and potential for innovation. Innovation must touch all aspects of the patient journey - and indeed the experiences and involvement of carers and staff.  We need to nurture a culture of innovation where every member of staff feels free to suggest improvements to their part of the organisation.
• Innovation is about fostering rapid, entrepreneurial ideas that make a difference locally. Whether that is on a single ward, a single clinic or across an organisation or community. It has to begin with and where people work on a daily basis.
• Generated by users - patients, carers, visitors. The very best organisations in the world know that harnessing their users or customers is often the most powerful, effective way to innovate. Their input must guide and stimulate innovation.
• There needs to be a cultural shift so that a passion for change and improvement is seen as a priority for all employees. In addition to “did your doctor wash their hands?” we should be asking “how did your doctor improve the service this month?”