Comment / Open to ideas

The phrase ‘necessity is the mother of invention’ is often used in reference to those times when you are inspired to create something new because there is simply no other option. Growing up with a physical disability, my stubbornness frequently overtook my apparent inability, and I worked out how to do something my way rather than miss out on the experiences of childhood. 

The same can be said for healthcare innovations that arise from the need to improve health outcomes and patient experiences – and accepting that the status quo is simply not an option. The most recent and dramatic example is the rapid development of vaccines to protect us against Covid-19.

Innovation in modern healthcare encompasses treatments, technology and processes that enable clinicians to focus on the needs of patients and the wider population. The expansion of digital technologies provides the potential to offer new solutions to complex problems. Some of these have been explored in the series of case studies that the HFMA has published as part of the delivering value with digital technologies programme, supported by Health Education England.

For example, the HFMA’s recent case study, A model for innovation describes how Alder Hey Children’s Hospital NHS Foundation Trust has delivered a range of projects at scale through its innovation hub.

Not all problems require a complex digital solution. One of the recent innovations at Alder Hey was a clear mask developed to support communication. It was developed after one of the trust’s speech and language therapists asked for a solution to delivering therapy while wearing a standard surgical mask. It is especially useful for patients or service users with hearing difficulties, those with cognitive problems, younger or vulnerable patients, and those with learning disabilities.

Sarah Tyers, medtech funding mandate lead at NHS England, argues that for change to happen, the following must be in place:

• dissatisfaction with the current position – identify what is wrong
• vision – the awareness of a better alternative; identify how to fix the current position
• identification of the steps to achieve that better alternative
• belief in a positive outcome – that the problem can be fixed
• ability to deliver sustainable change.

Key to this is understanding the problem and having a solution in mind. The people usually best placed for this are the frontline staff, patients, service users, carers and other stakeholders.

Not all proposed solutions will result in the desired outcomes, but innovators need to be given freedom to be curious and experiment without fear of failure. Innovation thrives in organisations where senior leaders are open to ideas and invest time and resources into developing solutions.

This may not sit comfortably with finance teams, who are used to embarking on projects with clearly defined outcomes and benefits that can be measured. This is arguably even more the case at present, given the financial and operational pressures on the service. But teams need to recognise that, in the longer term, innovation is seen as one of the keys to achieving financial sustainability across the NHS.

How this apparent dichotomy is addressed will depend on the culture, risk appetite and fund availability in organisations. One example from Dorset Healthcare NHS Trust is a Dragons’ den-style annual staff innovation competition where staff are encouraged to put forward an idea that, if shortlisted, goes forward as a pitch for project funding and management support to make their proposal a reality.

The role of finance in supporting innovation and digital transformation was captured perfectly by Ben Roberts, assistant director of finance at Leeds Teaching Hospitals NHS Trust, in an earlier HFMA case study. He argued that finance teams need to be the architects of a solution that fits within the main constraints of quality and finance. ‘It is not our job to say no, it’s our job to make sure we’re getting value for the taxpayer,’ he said.