Following the publication of NHS England’s blog post on “how to bake innovation into the NHS” and the key ingredients for success in this area, we looked at some of the practical and strategic ways in which trusts across the country are embracing innovation and developing innovative strategies to meet health system challenges.
Placing research centre stage at University Hospitals of Leicester
University Hospitals of Leicester (UHL) NHS Trust recently published its Research and Innovation Strategy 2023-28, outlining plans to drive innovation through active research and partnerships with universities, enhanced access to healthcare data, and medical technology.
Working with the University of Leicester, UHL has attracted “substantial” external research funding and hosts facilities including an NIHR Biomedical Research Centre, an NIHR Clinical Research Facility, and an NIHR-CRUK Experimental Cancer Medicine Centre.
The strategy sets out the aim for UHL to take a lead role in developing and implementing an ICS-wide research strategy with the aim of maximising collaborative opportunities and ensuring that research becomes a key pillar to achieving the best results for patients. It celebrates partnerships such as those with the University of Leicester, for enabling the advancement of “new medicines and medical technology innovations to impact on healthcare for our multi-ethnic population”.
Using examples of virtual wards and AI detection of lung cancer, the strategy highlights plans to work across the ICS to develop IT to enhance access to healthcare data for research from patients receiving care in hospital, virtual wards and in the community.
Other plans include increasing the number of clinical trials, using social media to increase awareness of clinical research, working to ensure research is embedded “from board to ward”, and designing innovation challenge competitions for UHL staff.
Investment in infrastructure and innovative technologies at Leeds Teaching Hospitals
Leeds Teaching Hospitals NHS Trust’s Research and Innovation Strategy, running until 2025, focuses on three ambitions: to deliver high quality clinical research, to champion this research, and to grow a world-class clinical infrastructure and assets for research and innovation (physical and digital).
On engagement, the strategy highlights the importance of the trust’s underpinning philosophy that “research is for all”, committing to increase the visibility of research to patients and staff, invest in the trust’s Research Academy as an “internationally-recognised incubator for research delivery training”, and develop an ‘Innovating the Future’ programme to support staff with innovative ideas for new technologies.
Digital technologies will also play a key role in developing the trust’s research operations, with aims including the continued development of digital tech to track and monitor performance to inform resource allocation, and developing the skills required to deliver new trials relating to technologies such as AI and real-world data studies.
The strategy highlights the need to “take a proactive approach” to developing partnerships with SMEs and companies in industries including biotechnology, medical devices, AI and digital, to help “accelerate the development, evaluation and adoption of new products”.
On digital and data, the strategy emphasises the “transformative” role that data will have for healthcare in the future, committing to developing a programme of work to digitally enable the trust’s research, working with partners to “develop a portfolio of high quality research which utilises real-world datasets”, and developing capabilities to provide de-identified datasets for research.
Finally, on infrastructure, the strategy points to the £10 million investment in research infrastructure and the creation of new facilities in the ‘Building the Leeds Way’ programme, including the £3.3 million clinical research facility at St James’s campus for early-phase clinical trials of new drugs, devices, and diagnostics.
Innovation and quality improvement at The Clatterbridge Cancer Centre
The Clatterbridge Cancer Centre’s Innovation Strategy 2023-25 places a focus on the trust’s commitment to “taking its place at the forefront of healthcare and innovation”. “Be Digital” is one of six strategic priorities set out by the strategy, in terms of identifying, leveraging and creating digital innovations and technologies to transform the organisation.
On supporting the adoption of innovation, the strategy highlights the Centre’s commitment to providing faster access to new treatments and ways of working, taking a “flexible and agile approach to change”, and relying on rapid assessment frameworks and pilots to test new concepts for adoption. This will include a commercial evaluation service to “support the validation and subsequent adoption of newly developed products”.
Over the next three years, the trust aims to help a shift in culture to encourage staff to “spot problems and suggest solutions”, to provide access for staff to resources for self-improvement and skills development, and to establish a process for the evaluation of innovations.
Innovation pathways: study highlights “difficulties faced by the NHS in encouraging and adopting innovations”
A study published in the Therapeutic Innovation & Regulatory Science journal has looked at innovation pathways within and around the NHS, considering the extent to which they address “current challenges faced by innovators” and “areas for improvement and future study”.
On regional pathways, the study refers to Academic Health Science Networks (AHSNs, now known as Health Innovation Networks) as “perhaps the most important regional infrastructure for innovation”, noting that they are “well placed to take advantage of individual academic and industrial strengths of regions”, drawing on strategies such as using innovation scouts and working closely with university research hubs. It also notes the role of Applied Research Collaborations, with the specific aim of accelerating the rate innovative research is adopted in clinical practice; and Regional Medicines Optimisation Committees which are able to propose their own priorities, facilitating “top-down and bottom-up consideration of innovation priorities and policy changes”.
In terms of national pathways, the study identifies nine, including the Accelerated Access Collaborative, NHS England, NIHR funding schemes, the NHS Innovation Accelerator and Innovate UK. It notes the AAC’s role in providing a “single front door to the innovation ecosystem”, as well as its provision of training to help clinicians bring innovations to market.
Finally, the study presents several alternative innovation pathways, including angel investors, venture capital, start-up accelerators, and equity crowdfunding.
The study moves on to discuss the challenges. One such challenge is “the fragmented nature of the NHS”, which authors find presents barriers particularly for SMEs “who may be unaware of impactful regional variation” in digital or bureaucratic structure. Authors also identify challenges in accessing clinical data for SMEs and early innovators, barriers in accessing funding and support, and “the earliest invention stage” which is often ignored or overlooked.
To conclude, authors offer recommendations include “expanding and clearly defining the leadership role of the AAC in the innovation landscape” to overcome the existing fragmented nature of support pathways, and providing more support for innovators at the earliest stage of the innovation process – invention. The “pressing need for a high-quality, independently funded review of the innovation landscape” is also recommended.
Citation: Anmol Arora, Andrew Wright, Tsz Kin Mark Cheng, Zahra Khwaja and Matthew Seah. Innovation Pathways in the NHS: An Introductory Review. Therapeutic Innovation & Regulatory Science (2021) 55(1) pp.1045-1058. DOI: https://doi.org/10.1007/s43441-021-00304-w (license here).
Driving innovation by enhancing the “NHS-academia interface”: findings from the Academy of Medical Sciences
After consulting with stakeholders across the health sector, the Academy of Medical Sciences published a report offering six key outcomes it believes are “essential for enhancing the interface between the NHS and the UK’s academic biomedical and health research sector”. These are: creating a health system which “truly values research”; fully integrating research teams across academia and the NHS; allowing NHS staff time for research; equipping healthcare staff with the skills to engage with research; embedding flexibility into postgraduate training pathways; and streamlining research through joint R&D offices.
On creating a healthcare system that truly values research, the report recommends that NHS trusts and Health Boards “should have responsibility for valuing and promoting research across the organisation, and annually publish information on the outcomes and benefits of all of its research activities”; and that organisations including NHS England and NHS Improvement should work to develop research metrics to evaluate research activity in primary care and encourage GP practices to engage in research.
Under the header of integrating research teams across academia and the NHS, the report recommends that funders of research should “develop schemes to encourage greater mobility across sectors”, that higher education institutions should provide honorary clinical academics with access to infrastructure such as “grant-making machinery” and journal subscriptions, and that higher education institutions should consider offering honorary academic appointments to healthcare professionals who “contribute significantly to research”.
To provide NHS staff with time for research, the report recommends the launch of a pilot scheme where a proportion of consultants are offered a contract including dedicated time for research, and that income generated through NHS research activity should be reinvested back into research endeavours.
Recommendations under the remaining three key outcomes include the provision of professional opportunities for development for healthcare students, and the development of a “more integrated research office function” between NHS R&D and higher education institution research offices.
To read the report in full, please click here.
