Publications Nuffield Trust (UK): Achieving scale and spread: Learning for innovators and policy-makers

Hemmings N, Hutchings R, Castle-Clarke S, Palmer W (2020) Achieving scale and spread: Learning for innovators and policy-makers. Research report, Nuffield Trust.

Authors' abstract

In recent years, a significant number of innovators have forged ways to scale and spread innovation in the NHS. However, despite some existing work in this area, less is known about how to achieve greater scale and spread beyond early adopters. The Nuffield Trust was commissioned by the NHS Innovation Accelerator to help fill this knowledge gap.  

With the NHS under pressure to meet rising demand, the use of proven innovation is likely to be part of the solution to meeting that demand. The NHS Long Term Plan recognises the wide-ranging benefits to patients from innovation, and sets out the latest proposals in a decade of concerted national policy effort to ‘speed up the path from innovation to business-as-usual’.

The NHS undoubtedly offers considerable opportunities for innovation. More comprehensive and consistent access to innovations has the potential to benefit not only patients but also the wider health system (through, for example, reduced system costs over the medium to longer term). However, innovators face significant challenges given the in-year financial timeframe within which the NHS operates. The NHS is also inherently complex for innovators to navigate when seeking to achieve more comprehensive adoption of their innovations.

In this environment, we sought to understand:

  • the proactive tactics that could support more comprehensive adoption of innovation in England
  • the factors affecting NHS organisations’ decision-making, motivations and experiences when adopting innovation.

This research has been produced primarily as a practical resource for innovators working with the NHS. We conducted a review of the existing literature and semi-structured interviews with a range of innovators and adopters. We then developed a conceptual framework and used a workshop with innovators and a policy roundtable to draw out considerations for policy-makers.

The majority of the considerations we have identified are primarily directed at innovators; however, we also identified some national policy implications.