How can ICSs be better supported to adopt proven new technologies?

The NHS must improve its approach to adopting innovative technologies, rather than only focus on the innovations themselves. There are barriers to making that happen, not least workforce and capacity, but integrated care systems offer an opportunity to drive better adoption.

These were the key messages from an HSJ webinar, held in association with iRhythm Technologies Ltd, which discussed how ICSs could be better supported to adopt proven new technologies.

Dr Malte Gerhold, director of innovation and improvement, Health Foundation, said it was important to give the NHS credit for what it had been doing to realise the opportunities from new technologies, but more needed to be done. “In the last few years we’ve put a lot of emphasis on innovation, but not a lot of emphasis on what good adoption looks like and what the enablers are,” he said. “We’ve been looking at the front end of how we bring innovation in, not so much about how we take further the adoption.”

Professor Phil Richardson, who, at the time of the webinar was executive director for NHS Dorset ICS and a board member of Wessex Academic Health Science Network, called for a new way of looking at adoption. He said that any new technology should be considered as part of a wider system, rather than in itself, and that different systems across England would have different priorities.

“I think there is as much need for innovation in adoption as there is for innovation creating products and services,” he said. “I’d like to talk about innovation being a universal application rather than a creation of a product or a service or intervention.”

Collaboration is important, said Prof Richardson, who described how Wessex AHSN was currently being built out into Wessex Health Partners, bringing together all NHS organisations, research groups and local universities into a cohesive partnership. This gives innovators somewhere to go to, but also is a resource for systems that need a solution to a specific issue, he added. “One of the challenges you have if you’re facing queues of patients and daily pressures, you need somewhere to go and get a quick answer from somebody who can help sort that out for you.”

ICSs are focused on care at scale, and the economics of that, rather than looking at a single product in isolation, he added, and the local context, and local knowledge, is key.

Kerren Hughes, director, international HEMA, iRhythm Technologies Ltd, agreed that there needed to be more innovation in adoption. This includes moving away from the traditional tariff system, to one where procurement is based on the value that comes out of using a particular product or service. iRhythm has taken that approach in Liverpool, where it has supported implementation of its innovative cardiac monitoring device and system, Zio (see case study).

Prof Richardson said that Dorset had been using block contracts since around 2015 so that spending – whether on staff, equipment or medicines – could be decided based on outcomes. We need to look at value in a broader way, as it affects the whole system, he said, but added: “It’s really hard when you measure your financial performance by organisation.”

He called for more clinical focus on experimentation – in order to get the evidence to show how things could be done better.

In response to audience questions, the panel also discussed how to tackle variation in care, and to learn from success. Dr Gerhold said that while local context was important, that didn’t mean that something couldn’t work well across many areas. “What we don’t do very well at the moment is to look at spreadability,” he said. “To have something that happens in one organisation or system and ask ourselves ‘could it work elsewhere?’.”

Ultimately, he said, the NHS everywhere was looking at how best it could deliver for patients, and this might be done differently from area to area. “Variation for me is an opportunity to identify improvement, and then learn from that improvement across the country.”

ICSs have an important role to play in that, and relationships and a shared culture between staff in organisations across each system are key. “If that isn’t in place, it will stop any innovation and experimentation in its tracks.”

A recording of the session is now available.

For those who had previously registered for the webinar, click here to view the on demand recording.

For those who have yet to register, click here and complete the form. Details of how to access the on demand recording will then be sent to you via email.