Innovating out of the recession in the
NHS
Steve Barnett, Chief Executive
NHS Confederation
28th October 2009
Foundation Trust Network - Primary Care Trust Network - Mental Health Network NHS Partners Network – Ambulance Service Network - NHS European Office SDO Network - Health Services Research Network - The Welsh NHS Confederation –
Northern Ireland NHS Confederation
Where are we now?

NHS needs to plan for real terms funding cuts of £15bn over five
years from 2011.

Taking into account cash releasing requirements, the actual
impact could be up to £20bn.

Roughly equivalent to the annual NHS drugs bill and mental
health bill combined.

Additional rising healthcare costs, questions about size and skills
of NHS workforce, and the changing needs of the UK population.
Innovation and recession

Promoting and nurturing innovation is critical for the NHS in the future.

Recession will put major focus on delivering efficiency gains within the
NHS

Identifying opportunities to innovate should be central to any efficiency
drive.

Impact of the NHS on the rest of the economy.
Innovation in the NHS - history

NHS Next Stage Review highlighted poor record of the NHS in exploiting
innovation.

High-level inquiries including two taskforces set up with the
pharmaceutical and medical devices industries were set up.

Focus on invention and adoption and spread of new technologies/service
models.

NHS Confederation paper ‘Leading Innovation’ suggested that some
barriers to adoption of new ideas are within organisations rather than at
national level.
Where do new ideas come
from?
National Innovation Centre
NHS Innovation Hubs
National Institute for Health and Clinical Excellence (NICE)
Centre for Evidence-based Purchasing (CEP)
NHS Confederation and other organisations sharing good practice models and
policy thinking
Staff crossover from other parts of the NHS
Specialist societies and journals
Commercial sector
Universities & medical schools
etc….
Challenges for innovation

Evidence – lack of good randomised control trial-based and/or cost
effectiveness evidence.

Pilots often too small or in too narrow a part of the system – integrated
treatment centre pilots.

Cultural issues with technology - impact on structure of clinical work –
changing social structures of organisations and power relationships.

Skills – innovation frequently requires clinical champions - don’t have skills
or knowledge required to write business case.

Innovations fall into category of ‘growth’ money and compete against each
other.
What can we do?
Boards and leadership key to promoting innovation,
adoption and quality improvement – creating ‘safe to
innovate’ environment:







Protected time for staff
Using patients and front-line views on improvement
Support in sourcing innovation
Visits/secondments to other organisations
Learning networks
Benchmarking/peer review
Links to appraisal system
Paving the way for innovation

New vs old – subject existing therapies, systems etc. to
same level of scrutiny as innovations.

Innovation budgets and time, plus personal and
organisational incentives.

Costing and evidence-bases.

Maintain active database of best practice, innovation,
quality and outcomes

Create supportive context for innovation
Conclusion

As cost pressures increase need for significant changes in
practice.

Innovation, adoption and flexibility more vital skills of
leaders and competencies of organisations.

Vital to clear away barriers, create culture of continuous
redesign, improvement and challenge to existing practice.