Innovation is the core of what makes any good business run effectively. It seems almost superfluous to extol the virtues of modernising, but when it comes to the NHS it’s important to keep talking and keep reminding people. There are serious cracks in the NHS that lie far deeper than what is commonly known, and those thick fissures are only growing larger the longer they are left unaddressed.
As much as we’d like to believe all of the NHS’ problems would be solved by investing more money, it wouldn’t address a core issue at it its heart: its fear to adapt and adopt innovative practices.
I was working at the NHS when the National Programme for IT was disbanded. I saw first-hand what a large-scale failure looks like. Seeing half of NHS London’s office swarmed by contractors after the programme closed down was a reminder of how NHS run innovations can go terribly wrong.
One reason that the NHS has struggled to innovate is the intrinsic reward system for decision-makers. Policymakers are not rewarded for the upside; they’re geared towards downside-protection. No one has forgotten the The National Programme for IT disaster, and NHS leaders will do all they can to avoid another one. The concept of not wanting to do bad shackles the NHS before it even tries to take a single step. The NPfIT did nothing but strike fear into the hearts of administrators, to see a project with such good intentions go so badly wrong.
This is understandable. As a public body there is serious political pressure to not put a foot wrong. Accountability is a good thing, it helps the NHS make sensible decisions that attempt to safeguard the funding and confidence in it.
However, risk taking is important for any organisation if they want to make progress.
The AHSN Network did an investigation into large private sector companies (Apple, GE Healthcare, Johnson & Johnson) and found they spend as much as three times on distributing innovation as they do on its development. In the NHS it is the opposite. It spends over £1.2bn on R&D funding and only a tiny portion of that spreading it.
The NHS wants to innovate, but it finds it difficult to put procedures into place that can be consumed by the organisation as a whole.
The NHS haemorrhages billions of pounds every year on agency staff. They have tried to correct this problem by establishing NHS Professionals – the NHS’s own internal agency – but it was fraught with problems. Terrible customer service and poor implementation of technology undid many of the good intentions. Last year, when the government tried to sell NHSP, we were reminded of the fears associated with being bold. The sale was cancelled at the last minute for fear of privatising by the back door.
Politicians are terrified the public perception that the NHS is being privatised via the backdoor. In today’s political climate that is totally understandable; confidence in the private sector to handle data in an ethical manner could not be lower.
A case study by the Nuffield Trust found that clinicians felt outside businesses looking to collaborate with the NHS were not doing a lot wrong and generally worked well with the NHS.
At Lantum – an NHS staffing platform – I work towards the same goal as companies like WaitLESS, FREED, and ORCA as part of the NHS Innovation Accelerator. Small but accessible projects like reducing wait times, focusing on eating disorders, and rating the healthcare apps. Our shared pursuit is to scale across the NHS and scale beyond the pilots we have secured.
Our issue is that because of the departmental nature of the NHS, you see innovators like us win a lot of small-scale contracts. This can be a good thing in the short term, because it allows a hyper-focus as well as a fast way to create an evidence base.
There are so many cutting-edge innovations within the NHS, but when it comes to scaling up the benefits, they’re hindered by a lack of support from the top down to help wide-scale implementation. There are more pilots in the NHS than at Heathrow – is a popular term used by many who work in and for it.
The NHS needs to proactively look for success stories and combat this problem now. The wonderful NHS Innovation Accelerator has less funding this year than last, and is run mostly off the goodwill of some fantastic people from within the NHS who care deeply about scaling up innovations.
The NHS needs to embrace a culture where it looks to bring the best tools on board and not get stuck in the methods of old. Businesses in the private sector that fail to adapt to the demands of the modern world die out. It is only because the NHS is a public service that it has been allowed to list so horribly in the sea.
As time goes on, its problems will only magnify as the swell worsens. It is no use patching and repairing it when it needs to be fitted with a new interior that can deliver its core services. The NHS is one of the greatest achievements in this country’s rich history – it is our duty to help it so that it can help us.
Melissa Morris is the CEO of Lantum