Editor's Comment

01.10.15

The benefit of growing at scale

Source: NHE Sep/Oct 15

Dr Lloyd Humphreys, NHS Innovation Accelerator fellow and vice-president of business development at Patients Know Best, explains how to stop innovations from getting stuck at the local level.

At Patients Know Best, our ambition is for every citizen in the UK to have access to their medical information – and to do so in a way that empowers them to manage their wellbeing and starts to change how they interact with doctors and healthcare professionals. 

To achieve this, we need a solution that’s scalable and adopted across whole populations. We know that when this happens, it can have dramatically more impact than if it’s implemented in a piecemeal or localised way. 

Fortunately, how to do this is exactly the challenge being addressed by the new NHS Innovation Accelerator (NIA), a programme we were delighted to win a place on in July this year. 

Pockets of innovation 

The NIA recognises that on average it takes 17 years for an innovation to be adopted at scale within the NHS. They know that timeframe is way too long, and we agree. Whilst there is some amazing work taking place in the NHS, unless that learning can be shared and adopted nationally, its impact on patient care will always be limited. 

At the moment, NHS structures and cultures aren’t always set up to encourage the growth of nationwide innovations. Commissioning structures within the NHS often lead to innovation remaining in pockets throughout the country. 

One reason for this is that local procurement budgets often keep innovations within small geographic areas – limited in size, scope and ambition. Another is that multiple stakeholders inside and outside the NHS are often involved in the care of patients with even quite simple conditions. 

This makes having any nationally-coherent procurement process difficult to achieve. It also makes it very difficult for commercial enterprises to navigate an increasingly complex NHS and means that innovations are often deployed piecemeal to work with specific patient groups. 

That’s why an important part of the NIA programme is to teach businesses like ours how to navigate and engage with the complicated procurement and commissioning structures within the NHS – as an NIA Fellow, this has been a fantastic learning experience for me. 

Changing behaviours 

Patients Know Best is already having a positive impact on patients’ lives across the country. Our technology is operating in 80 sites across the UK with plans to be in 200 sites by the end of the year. That’s great but we want adoption of our technology across whole populations and regions. 

If Patients Know Best is deployed more widely throughout a region or a population, it becomes more than a technological solution. It becomes a lifelong wellbeing platform. 

We know that when patients take control of their medical records they also change their behaviour. They become more empowered, they question things, they feel more responsible for their own care and they look after themselves better. 

Influencing policy 

We have, to date, taken a ‘bottom up’ strategy in that we encourage local implementation of the technology with a view to tying all these sites of innovation together. 

That’s worked well so far, but with the NIA’s help, we’re now engaging with central bodies such as NHS England to understand how our patient-controlled records approach can inform wider national policy objectives and aims. 

In addition, Patients Know Best is involved in a number of innovation workstreams and our technology is currently built into an innovation Test Bed application across Leicester, Lincolnshire and Rutland to explore a cross-boundary medical records solution. 

We’re also working with Staffordshire and Stoke-on-Trent Partnership NHS Trust on the roll-out of patient-controlled records across community services – an exciting integrated deployment that will be seen across different sets of services from adult social care to school nurses. 

When technologies like Patients Know Best are adopted quickly within the NHS, they become not just innovations that make some people better. Rather, they become solutions that improve the health of whole populations and encourage more collaborative patient-clinician relationships – and that’s the real benefit of growing at scale.

FOR MORE INFORMATION

W: www.england.nhs.uk/ourwork/innovation/nia/

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