NHS Horizons has released seven detailed approaches to help healthcare leaders and organisations ‘spread and scale innovation’ across the wider healthcare system.
Approach one: building capacity and capability
NHS Horizons identifies five methods which will help build capacity and capability within an organisation, and which can enable development of skills on a personal and organisational level.
The methods suggested include setting selected individuals such as innovation fellows on national skills and coaching development programmes; dedicated resource provision to support frontline adoption; provision of training and broader development to increase capacity of local staff in supporting innovation; innovation-specific capacity building; and deploying learning systems to inform, review and improve care services.
Approach two: networking, peer learning and collaboration
NHS Horizons notes the impact that networking, peer learning and collaboration methods can have in enabling better communication for staff and patients, allowing them to work together with a shared focus.
The guidance makes a number of suggestions, such as fostering collaboration between groups with a common interest or purpose to share insights; ensuring co-production with end users; ‘patient pull’, through which patients are encouraged to advocate for the adoption of new innovations; and providing an broker for discussions where there is lack of existing trust or knowledge between parties.
In addition, NHS Horizons highlights the importance of leadership support and champion roles, the creation of partner networks within and outside the NHS to share knowledge, and collaborative schemes through which organisations can work together to introduce change.
Approach three: piloting and rolling out
Here, NHS Horizons shares how pilot schemes and subsequent roll-outs can assist in the spread of innovation through application of insights learned at an earlier stage.
The guidance notes how learnings gained from supported and selected demonstrator sites can be distributed across a wider audience, and pilot schemes can also involve honing the intervention or determining which aspects are essential versus which are adaptable or discretionary.
Approach four: coordinating through large scale engagement and national programmes
In order to coordinate effectively through large scale engagement, NHS Horizons states, methods are required “to provide focused coordination to commission in the delivery of large scale improvement.”
For coordinate the roll out of a national intervention, the guidance states, there is a need for cross-boundary collaboration, focused oversight and regional management.
It suggests that large groups or organisations should be challenged to address diverse issues and solve shared problems together, making the most of competition and crowdsourcing.
In addition, a recommendation is for teams and organisations to be enabled to deliver a proven intervention to agreed standards under a franchise agreement, with the primary aim to “maximise social benefit”.
Approach five: investing and incentivising
In this area, NHS Horizons share a number of investing and incentivising methods that can be used to support in utilising new procurement and contracting agreements, assisting with pricing, and provision of additional funding.
The methods are: performance-related funding, which drives uptake of proven intervention; flexible commercial deals, through which new methods of procurement are created to facilitate more flexible prices, services and support; commercial agreement, using national purchasing power to achieve agreement with commercial companies to enable other incentives; and building natural incentive for use of products by linking prices to levels of adoption and usage.
Other methods listed include providing additional funding to early adopter sites, to manage pathway transformation costs; setting estimated uptake numbers and monitoring delivery at national or regional level; utilising benchmarking to create behavioural incentives or drive patient advocacy; and utilising technical standards and specifications to enable choice in tech.
Approach six: governing and assuring
“Methods that involve governing and assuring provide clarity on what is expected and required,” the guidance states, thus encouraging spread and scale of innovation.
The five methods identified in this approach are regulation, inspection and clinical audit; contractual obligation; specific product signal; national signals or campaigns; and national mandates on product availability.
“The effective of these methods will vary depending on context,” it notes, adding that the key strengths of these methods include their ability to provide clarity, support peer learning between systems, provide intelligence to support local decision-making and prioritisation, and support exit from more intensive processes to achieve spread at a sustainable rate.
Approach seven: identifying and communication priorities
Identifying and communicating priorities relies on “sending clear signals to national and/or local systems or bodies about the need for spread and scale in a specific area or for a specific intervention.” the guidance notes.
The methods listed are local needs identification to send signals to commissioners about priority areas; horizon scanning, or analysis of data to produce a pipeline or market innovation and research; development of national clinical guidelines which place intervention as part of best practice in a particular pathway; and inclusion of intervention in commissioning guidelines or governance.
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