Operational pressures, financial challenges and a infrastructure limits have stretched the NHS: Its services are suffering as a consequence.
The first Curia and NHS Innovation Accelerator “Sprint” Workshop focussed on what shifts can be made to create a national health system for the future. One that is resilient to global and financial pressures, which puts patients and care first, and that embraces technology and innovation, helping to reduce pressures on overworked staff.
The workshop heard from a variety of voices in the field, including Rt Hon Andrew Stephenson CBE of the Curia Health, Care and Life Sciences Research Group, Chris Bird, Project Director and Chief Transformation Officer at University Hospitals of North Midlands NHS Trust, and Eddie Oller, Chief Digital Information Officer of Coventry and Warwickshire ICB.
They shared their thoughts on a number of issues, sharing expertise and coming to the conlcusion that progress was not hampered by a lack of ambition, skill, or ideas, but instead by structural, cultural and leadership barriers. They identified six core themes that were explored in depth highlighting the challenges the current system creates and faces, and recommended actions that could transform NHS services.
The innovation paradox: Why good ideas fail to materialise
The NHS is full of intelligent, vibrant innovators who want to, and will, work hard towards a better system, but a number of obstacles stands in their way.
The structural and cultural hierarchy means that those at the bottom of the system, often the most engaged in care and the day-to-day of service provision, feel as though there is no ability for them to implement meaningful change.
For others, they fear they are overstepping their mark, or fear the risk of a career or reputational set-back if their innovative idea or system fails.
It is evident that for innovation to be effectively managed and implemented, it must be nurtured through collective workplace values and new practices that allow for new approaches to be trialed with supportive leadership and guidance available.
High costs are also a recurrant problem, with uncertain funding meaning that trials must be successful immediately, with “success” often vaguely defined, instead, workshop participants believed that innovation must be given time to grow and adapt with pre-agreed key performance indicators (KPIs) to give stake holders confidence in the process.
Culture, governance and leadership are all levers of innovation, with ambitious teams able to implement tangible reform, but for this to become the norm the attitude of risk aversion and a fear of failure must be changed that the NHS can grow into the future.
Strategy for progress: The seven barriers to innovation
Participants in the workshop were united in their belief that meaningful innovation cannot be achieved without systematic change at the national level.
The current landscape hampers innovation and creativity, while a lack of alignment between national policy ambitions and operational realities often leads to those in leadership inadvertently acting against front line service providers.
To enable innovation to succeed, delegates identified a series of strategic enablers that require urgent attention from national leaders and policymakers
1. Reform procurement to support outcomes
Procurement processes across the NHS remain a substantial barrier to innovation adoption, particularly for SMEs which are often blocked or overlooked in favour of large incumbents which are more adept at navigating the complex and prolonged tendering frameworks built into the current system.
Streamlining and standardising procurement templates across ICBs and NHS trusts would allow smaller actors break in to the space, sharing their expertise and innovative processes.
This, combined with dedicated innovation carve-outs within new procurement regulations could enable small-scale trials and experimentation from which outcome-based contracting, based on trials meeting defined KPIs, could drive both innovation and growth in the health sector.
2.Simplify and align governance
Beauracracy and red tape was frequently cited as a key frustration for would-be innovators, with repeated information guidance and clinical safety assessment slowing down the procurement process.
Workshop participants tabled the idea of a national innovation sandbox – a secure environment where data protection and safety processes are harmonised, enabling faster testing and deployment of promising technologies, cutting the time required for administrative tasks in the adoption process.
3. Introduce a national adoption pathway
There exists a “innovation chasm” between successful trials and pilots and long term adoption and scaling into the national health system, to address this, a structured national adoption pathway was proposed.
A three year contract model (first year: free, second year: co-funded, third year: fully funded) would allow high performing SMEs in particular to plan for a scaling process upon successfully meeting KPIs and the implementation of pre-agreed KPIs and public investment commitments would give innovators the confidence needed to expand trials over this period.
To assist scalability, an automatic national endorsement of validated tools, akin to NICE approvals, would streamline the process and cut waiting times for adoption.
4. Mandate innovation leadership at board level
Innovation should not be siloed or optional. Delegates recommended that every ICS and trust appoint a board-level innovation lead with clear authority and accountability.
Just as safeguarding has a designated board champion, innovation should be treated as a strategic priority with visible leadership and ownership.
5. Fund regional innovation capacity
Whilst the NHS holds a host of proactive, passionate innovators, we cannot rely solely on goodwil or ad-hoc inniatives to turn ideas into practice, targetted national investment is needed.
The workshop suggested three major investments: Regional innovation taskforces, test-and-learn environemnts, and transisitonal funding mechanisms.
Regional taskforces, embedded within ICBs, and transitional funding mechanisms can help to guide innovators and support adoption while test-and-learn environments give frontline teams space and equipment to experiment safely.
6. Align national research funding with local need
Concerns were raised that national research spend is not always aligned with the most pressing
local population needs. Delegates proposed greater local influence over national research priorities,
alongside closer integration of research, innovation, and operational improvement efforts.
7. Engage the public in honest dialogue
Finally, participants emphasised the need for public honesty and engagement.
Innovation involves risk, and transformation requires change. National leaders must communicate clearly with the public about the trade-offs involved and actively include communities in shaping new services – ensuring innovations reduce, rather than exacerbate, health inequalities.
Final Thought
The NHS stands at a crossroads where the path forward is remarkably clear, even if the journey remains challenging. This workshop revealed that the health service doesn’t need more innovation – it needs the courage to implement what already works. The solutions exist, the evidence is compelling, and the roadmap has been drawn. What’s required now is the collective will to move from endless pilots to systematic national transformation.
The full report can be purchased here.
