How NHS challenges are driving an innovation revolution

Crit­ics fear the NHS is strain­ing, weighed under by the pan­dem­ic and soar­ing demand. These pres­sures are very real – but they’re also fuelling inno­va­tion. 

Faced with inces­sant chal­lenges, every­one from clean­ers to con­sul­tants are exam­in­ing ways of improv­ing the ser­vice. Bright ideas from hard-pressed staff are now rev­o­lu­tion­is­ing health­care deliv­ery, with staff deploy­ing inge­nu­ity and inven­tion to solve prob­lems. Wel­come to the NHS’s inno­va­tion rev­o­lu­tion.

The NHS deals with more than 1 mil­lion patients every 36 hours. Its 1.5 mil­lion staff face a tread­mill of demand, includ­ing 16.25 mil­lion hos­pi­tal admis­sions and 23.3 mil­lion acci­dent and emer­gency unit atten­dances every year.

But against a back­drop of ris­ing ser­vice demand and tight­ened finances, they’re devis­ing hun­dreds of inno­va­tions. These range from work­flow tweaks to treat­ment break­throughs that are trans­form­ing care and improv­ing effi­cien­cies.

Lifting the load

Despite the fre­net­ic pace of dai­ly NHS life – inten­si­fied by the pan­dem­ic – the health sys­tem has cre­at­ed a pro­gres­sive cul­ture of change. Staff are encour­aged to come up with ideas, then offered sup­port to scale and grow projects.

Hos­pi­tals around the coun­try are ben­e­fit­ting from such ini­tia­tives, includ­ing a one-stop prostate can­cer clin­ic, an arti­fi­cial intel­li­gence (AI) sys­tem that speeds up diag­noses and an app that min­imis­es main­te­nance issues that can ham­per surgery. A group of hos­pi­tal domes­tic staff also devised a bet­ter way of using clean­ing flu­ids to improve hygiene and save mon­ey.

The bright ideas are curat­ed by the NHS Inno­va­tion Accel­er­a­tor (NIA), which pro­motes and guides promis­ing ini­tia­tives through the health system’s bureau­cra­cy so they can

deliv­er ben­e­fits to patients. Over the last six years it has helped raise £188m in exter­nal fund­ing for inno­va­tions that are now used at 2,718 NHS sites and have saved the health ser­vice more than £40m.

“Who is bet­ter to cre­ate solu­tions than the peo­ple who work in the NHS every day and see where the prob­lems are?” says NIA inter­im deputy direc­tor Maria Kyr­i­a­cou. “These inno­va­tions show that the NHS and the peo­ple who work in it are doing every­thing they can to help the nation’s health.”

We have to inno­vate our way out of the pan­dem­ic by work­ing in a dif­fer­ent, smarter way

Indi­vid­u­als are com­ing for­ward with fresh ideas and smarter, more effi­cient ways of deal­ing with issues, Kyr­i­a­cou says, “and they are get­ting results. It is lift­ing the load off every­one in a sys­tem that is already work­ing so hard.”

Orthopaedic sur­geon Ash Kalraiya found­ed MediShout through the NIA, devel­op­ing a dig­i­tal plat­form for clin­i­cians to report prob­lems and use AI to pre­dict future issues. The idea came after he was forced to can­cel three oper­a­tions due to a bro­ken light­bulb in the oper­at­ing the­atre and delay anoth­er because he had to fix a faulty print­er at a Lon­don hos­pi­tal. 

“It allows hos­pi­tals to resolve the small logis­ti­cal prob­lems that have huge con­se­quences for staff and patients,” adds Kyr­i­a­cou. “It is sav­ing £1m a year in effi­cien­cies and is now being rolled out at some of the largest UK hos­pi­tals. It’s just one exam­ple of the cre­ativ­i­ty and solu­tion-based focus NHS staff pos­sess.”

Innovation pathways

NIA’s sup­port includes men­tor­ing and learn­ing pro­grammes. There are also net­work­ing oppor­tu­ni­ties, help­ing to get inno­va­tions adopt­ed across the NHS’s com­plex struc­ture of 207 clin­i­cal com­mis­sion­ing groups, 206 health trusts and 1,229 hos­pi­tals around the UK.

There are routes through this crowd­ed and often dis­joint­ed mar­ket, sign­post­ed by 15 region­al Aca­d­e­m­ic Health Sci­ence Net­works (AHSNs), which con­nect the NHS, aca­d­e­m­ic insti­tu­tions, local author­i­ties and char­i­ties. The net­work is host­ed by the inno­va­tion cat­a­lyst UCLPart­ners, which also acts as a medi­a­tor between NHS and indus­try.

The aim is to spot inno­va­tions that can impact the health and care sys­tem, help­ing to scale them up across the NHS to become busi­ness­es. In 2020–21 it sup­port­ed 2,888 com­pa­nies and lever­aged £462m of invest­ment while cre­at­ing 700 jobs and safe­guard­ing 763 oth­ers.

“We have to inno­vate our way out of the pan­dem­ic by work­ing in a dif­fer­ent, smarter way,” says Pro­fes­sor Gary Ford, chair of the AHSN Net­work and chief exec­u­tive offi­cer of Oxford AHSN. “NHS inno­va­tion is often focused on the way we work and using approach­es like dig­i­tal tools to trans­form care path­ways to meet the needs of patients. The peo­ple that best under­stand those needs work in the NHS.” 

While many parts of the health ser­vice are good at sup­port­ing peo­ple to devel­op their ideas with­in their own unit, the chal­lenge is spread­ing this around the NHS, says Ford. This is why AHSNs were cre­at­ed. 

“We pro­vide the right envi­ron­ment for inno­va­tors to work in the NHS and devel­op their ideas and curate them so they can be adopt­ed more broad­ly.”

Entrepreneurial teams

London’s Chelsea and West­min­ster Hos­pi­tal NHS Foun­da­tion Trust col­lab­o­rates with its char­i­ty CW+ to run the CW Inno­va­tion pro­gramme, which tests and scales staff-led projects that improve patient care and hos­pi­tal effi­cien­cies.

It co-devel­oped ISLA imag­ing tech­nol­o­gy, which remote­ly diag­noses rash­es, wounds and skin con­di­tions and has been rolled out across north-west Lon­don. The Trust also co-devel­oped a real-time algo­rithm for Covid-19 patients, pre­dict­ing their risk of ICU admis­sion, the need for mechan­i­cal ven­ti­la­tion and in-hos­pi­tal mor­tal­i­ty.

“Dig­i­tal inno­va­tion is front and cen­tre at the Trust,” says Chris Chaney, chief exec­u­tive of CW+. “Our inter­nal infra­struc­ture, entre­pre­neur­ial cul­ture and grow­ing part­ner­ships with exter­nal organ­i­sa­tions have all pro­vid­ed sol­id foun­da­tions for us to be able to respond quick­ly to the evolv­ing needs of our patients and staff.”

Who is bet­ter to cre­ate solu­tions than the peo­ple who work in the NHS every day and see where the prob­lems are?

The pan­dem­ic con­tin­ues to put enor­mous pres­sure on the NHS, Chaney adds. More than ever, the ser­vice must embrace new ways to care for and treat patients as effi­cient­ly and effec­tive­ly as pos­si­ble. 

“One of our Trust’s val­ues is ‘deter­mined to devel­op’ and we are extreme­ly proud of our entre­pre­neur­ial teams who have demon­strat­ed just that and remain com­mit­ted to main­tain­ing momen­tum and dri­ving a future of ongo­ing trans­for­ma­tion not just at our Trust but across the NHS,” he says.

Efficiency boost

At Frim­ley Health NHS Trust, urol­o­gy clin­i­cal spe­cial­ist nurse Tanya Gill was instru­men­tal in improv­ing care for prostate can­cer patients by cre­at­ing a one-stop clin­ic. The 42-year-old noticed that patients often had to make repeat vis­its as they were processed through a slow, labo­ri­ous sys­tem.

“Patients were wait­ing longer to find out if they did or did not have can­cer and that is very dis­tress­ing,” she says. “They were fac­ing lots of vis­its with park­ing charges and invari­ably had to repeat what was wrong with them to a new clin­i­cian every time they came.”

With the back­ing of her line man­ag­er and con­sul­tant, Gill reworked pro­ce­dures so patients could go from ini­tial meet­ing through MRI scans and poten­tial biop­sies to diag­no­sis in one day, which has result­ed in faster diag­no­sis rates and greater effi­cien­cy.

Con­sul­tant radi­ol­o­gist Dr Thomas Naun­ton Mor­gan devised Nighthawk – the out-of-hours radi­ol­o­gy report­ing sys­tem that pro­vides diag­nos­tics in peak peri­ods – while work­ing at West Mid­dle­sex Uni­ver­si­ty Hos­pi­tal. He con­tin­ued to devel­op AI sys­tems, found­ing behold.ai, a com­pa­ny that has cre­at­ed an algo­rithm that can spot abnor­mal­i­ties in images, sav­ing clin­i­cians time and reduc­ing back­logs.

Inno­va­tion from NHS staff is pump­ing through every artery of the health sys­tem. With wait­ing lists stand­ing at 5.7 mil­lion and pre­dict­ed to length­en, the NHS needs its staff to main­tain their ded­i­ca­tion and inge­nu­ity.

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