Innovation and change in healthcare journal article

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The role and importance of a university hospital for the innovation activity in the regional medical device industry: a case study from Switzerland. Rebild, Denmark. Wootton I. The past decade has seen a dramatic shift from largely paper-based health records to most GP surgeries and a growing number of trusts in the UK using electronic health records.

However, the task of digitising the NHS health record has been a long, complex and, at times, challenging process, 7 resulting in the purchase of a huge variety of different systems with consequent interoperability issues. The deadline for a paperless NHS started off as , 8 then 9 and the recent Wachter report now recommends aiming for Digitising the record is just the first step towards achieving healthcare improvement.

Benefits can only be truly realised once all the individual systems and databases have been connected, including enterprise systems, third party apps and patient-facing systems. At this point, we can start gleaning valuable insights from the data, and converting these insights into actions that will improve quality, safety and efficiency.

In the UK, we are currently addressing the challenges of achieving both digitisation and interoperability. By implementing the recommendations of the Wachter report, we will enable an interconnected, mixed ecosystem of IT system providers, and build the essential foundations for the health innovations of the future. Delivering fair and rational intellectual property treatment to innovators within the NHS is a vital ingredient to promoting innovation in the NHS.

Battles around intellectual property can result in great ideas being stifled, with the result that their potential is never realised. This is clearly not in the interest of the NHS or our patients. The Department of Health last published a framework and guidance on the management of intellectual property in the NHS in , 11 a time before the mainstream adoption of smartphones and when the internet was in its relative infancy.

We need to create an environment where the optimal place to develop an idea is within the NHS. In combination with access to funding, support and appropriate guidance, this goal can be achieved. Many great ideas fall at the barrier of regulation. Until recently, the ambiguity of how medical device regulation should be applied to medical apps has proved a challenge to many app developers across the NHS.

The Medicines and Healthcare products Regulatory Agency MHRA published welcome guidance in late , which explained the assessment process in much greater detail. This could help future innovators ensure that their apps are appropriately quality-assured for use in the NHS.

The NHS procurement process can appear baffling, complicated and unnecessarily bureaucratic. The coalition government recognised this problem in and the Department of Health subsequently published an action plan to support small and medium-sized enterprises selling to the NHS. The fifteen Academic Health Sciences Networks across the UK have helped facilitate this mission, connecting small businesses with the many components of the wider NHS, enabling innovation at greater scale and ease than was possible before.

All devices, services and pathways require evidence to support their introduction, and must show superiority to what is currently available, ideally at a lower cost. However, this evidence is difficult to acquire without access to patients or clinical facilities to develop and test prototypes.

Another important development was the creation of the new care model vanguards programme in This brings together partnerships of NHS organisations, local government, voluntary, community and other organisations in order to move from fragmented care to integrated care in communities.

There is already evidence that vanguards are improving local services, while reducing pressure on busy GP and accident and emergency services. Such incentives offer valuable opportunities for companies across the world to develop innovation at scale in the UK. There are many examples of promising innovation in the NHS, but very few that have been able to scale beyond their single local area or site. Firstly, additional energy must be expended in other areas to address the same problem.

Secondly, many highly localised solutions result in an overly complex organisation without common points for integration. However, focusing down too soon may prevent the innovations we need from being developed. This is the innovation dilemma faced in healthcare. As projects mature, it can remain difficult to distinguish flowers from weeds unless care is taken to innovate in a focused, managed way, linked to careful evaluation.

The NHS has chosen a pragmatic path through this by encouraging local innovation and national level support for scaling and spread. The NHS Challenge Prizes have provided funding, publicity and recognition to a wide range of fantastic ideas from across the country. For those already developing a specific innovation, the NHS Innovation Accelerator programme has provided the mentorship, knowledge, funding, and peer support to help 18 proven innovations to be adopted faster and more systemically through the NHS.

Another systematic challenge to the uptake and spread of an innovation is the resistance to change from the healthcare workers who will be impacted by it. As this growing cohort develops the skills, knowledge and experience to innovate within the NHS, we hope to see many great innovations graduating from the programme and being adopted at scale across the system.

As the largest single unified healthcare system on the planet, the NHS can appear a daunting place to innovate. However, that challenge is also an advantage. If you want to innovate at scale in healthcare, the NHS is the place. In recent years, a vibrant healthcare start-up community and culture of innovation is beginning to form within the NHS, which offers the potential to revolutionise future patient care.

We need to nurture this movement carefully, and work hard to address issues of regulation, intellectual property, funding, scalability and procurement. With appropriate focus, a culture of innovation will help the NHS to continue delivering world-class universal healthcare to the population of the UK.

Future Healthc J. Christopher J Kelly , NHS England clinical entrepreneur and clinical research fellow A and Antony J Young , consultant urological surgeon , director of medical innovation , innovation lead , national clinical lead for innovation B. Author information Copyright and License information Disclaimer. Email: ku. All rights reserved. Creating a culture for innovation Many NHS staff have great ideas for improving the system and patient experience.

Box 1. Key NHS offerings that contribute to a culture supporting innovation. Best practice tariffs — incentivise and reimburse providers for the cost of high-quality, innovative care.

Innovation Challenge Prizes — a national level celebration and reward for outstanding innovation in healthcare. Healthcare Small Business Research Initiative — pre-commercial procurement contracts for research and development in innovative healthcare products and services. Clinical excellence awards — rewarding clinicians for quality improvement, research and innovation. Academic Health Science Networks — 15 regional organisations bringing together healthcare, academia and industry on an open innovation platform to lead work in the NHS on adoption and diffusion of innovation.

NHS England Innovation portal — innovation connect and exchange provides support, advice and navigation through the system and is open to all who want to innovate and collaborate in healthcare. Innovation Scorecard — enables benchmarking and increases transparency for the variation of adoption in NICE technology appraisals.

They provide real world sites testing combinatorial innovations that can deliver better care, better patient experience of care at the same or lower overall cost. National Innovation Accelerator — a fellowship programme equipping innovators with the skills knowledge and experience to drive the uptake of their proven innovations across the NHS. Healthy New Towns programme — improving health through the built environment, reshaping the health of communities and rethinking how health and care services can be delivered.

A Continuing Clinical Innovation CCI points scheme — this will become part of the continuing professional development scheme. A framework will be provided that allows clinicians and their appraisers to award CCI points for innovative activity that will count towards their annual appraisal and revalidation.

The Innovation Technology Tariff — national level reimbursement for new medtech innovations 4. The Clinical Entrepreneur Programme — a workforce development programme allowing clinicians to continue their frontline NHS roles while developing their entrepreneurial ideas.

Open in a separate window. Accessing funding for innovation For new innovations to flourish and spread at scale, access to adequate funding is critical. Addressing some key issues There are a number of areas that present barriers to innovation in healthcare.

While privacy is very important, so too is data sharing The handling of confidential patient data is a fundamental requirement for many potential innovations in the NHS, and this has historically been one of the greatest hurdles to getting new products to market.

Interoperability is critical to improving healthcare quality, safety and efficiency The past decade has seen a dramatic shift from largely paper-based health records to most GP surgeries and a growing number of trusts in the UK using electronic health records. Intellectual property policy should not stifle new innovations Delivering fair and rational intellectual property treatment to innovators within the NHS is a vital ingredient to promoting innovation in the NHS.

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