Dr Jacqueline Andrews, Humber and North Yorkshire Lead for Innovation, Research and Improvement
Most agree that health and social care innovation is critical to improving patients’ and citizens’ quality of care and health and wellbeing outcomes. Where there is less agreement is where, in the never-ending challenges of funding and capacity, our appetite to prioritise innovation sits and what the agreed definition of “innovation” actually is.
Is research and development different to innovation, and should it be viewed separately as a different art form? Is quality or continuous improvement different to innovation or transformation, another commonly used catch-all term in health and social care to add to the mix? Does it matter, and in particular, do the patients and communities we serve recognise the differences or is it all viewed as just the public sector speak for “trying to make things better”? I believe that Integrated Care Systems are in a unique position to 1. demystify health and social care “innovation” once and for all and 2. achieve what health and social care systems have yet to crack- a simple, joined-up approach across an integrated care partnership which enables innovators to innovate and/or fail fast and move on, with the health and social care partners (plus investors and the economy) reaping the benefits quickly, efficiently and with minimal bureaucracy.
As someone who has worked closely with NHS, academic and industry research, innovation and improvement professionals and programmes throughout my whole career, I am increasingly of the view that in health and social care, we often overcomplicate things in our attempt to shoehorn each brand into different portfolios, teams and funding streams. By doing so, we risk turning the very people who are innovators (in the broadest sense) off due to complicated pathways, obscure acronyms and silo working. Furthermore, we also run the risk of alienating the very people we need to influence to invest in “R&I”, namely health and social care board members, many of whom are not familiar with research, innovation and improvement and do not see it as “core business” when faced with never-ending short term performance metrics and operational challenges.
That is why at HNY ICP, we have created a simple way forward to address our systems innovation needs, known as IRIS (Innovation, Research and Improvement System). IRIS will be known in shorthand as our innovation system. However, innovation, research and continuous improvement most definitely reside within it, side by side, managed by one team who have vast experience in all domains, and with one single point of entry for external stakeholders who find health and social care complex and challenging to navigate. Internal colleagues will have full access to the support provided by IRIS, for example, seeking match-making partnerships or demand signalling our health and social care challenges to external partners in academia and industry. For us, it seems a “no brainer” to link research, innovation and improvement together, as each is simply a well-trodden step along the “making things better” eco-system which covers all aspects of the inventing, developing, testing, refining, adapting, spreading and continuously improving feedback loop for new innovations (as a member of the public would describe innovation). IRIS acts in its simplest form as a single front door in and out of our integrated care system for all things related to innovation, breaking down barriers between health and social care providers, industry and academic partners, who often find the NHS impenetrable, where it is rarely anyone’s day job to do or support “innovation”, despite many innovators and innovative ways of working on display every day (and never more so during the COVID-19 pandemic when, due to almost all no urgent activity being suspended, colleagues had time and desire to innovate).
There has never been a time in health and social care where we have needed innovation and innovators more. Technology always has and will continue to shape healthcare, with a recent example being the rapid gains being made in AI in several medical specialities (diagnostic radiology and histopathology, to name two). Rapid advances in cardiovascular technology and therapeutics over the last 30 years have dramatically shifted the dial on CVD mortality and morbidity. However, many grand challenges in health and social remain, and clinical leaders and managers have limited bandwidth to address them due to relentless day-to-day operational demands.
In our Humber and North Yorkshire system, we have the mixed challenge of large areas of coastal and rural deprivation and a significantly older population than the national average, as is often the case in coastal and rural areas. Maximal ill health has until recently, clustered in urban areas. However, the shift from morbidity due to cardiovascular disease (heart disease and stroke- as described above) to age-related diseases will require a fundamental change in how we allocate funding and create capacity in health and social care. Ensuring we are undertaking research, innovation and continuous improvement projects and programmes in the populations of greatest need will be crucial to ensure we develop fit-for-purpose services to address the demographic changes we are facing now and in the future and support rural and coastal communities to manage the multimorbidity of their ageing populations.
The good news, however, is the biggest challenge we face in fully embracing innovation is also within our gift to fix. As a health and social care system, we must move from a longstanding culture of daily fire-fighting and endless loops of short-term planning and funding and embrace a brave new world of long-term goals to allow true transformation. Research, innovation and improvement methodologies are the critical tools we need to address our challenges. It is, therefore, very positive to see NHS England launch NHS Impact this year as the first step to ensure the modern-day NHS workforce is equipped with the tools to make the improvements we all desire.
The twin challenges of the COVID pandemic and the current cost of living crisis have made it challenging to achieve short-term gains in the nation’s health. However, it is essential to note that significant improvements in health have been made throughout every decade over the last century and will continue to be made if we act now and make research, innovation and improvement core business in health and social care, as it is in other successful business sectors. If any further persuasion is required, plenty of evidence confirms that organisations involved in research and innovation have better patient outcomes and are better able to recruit and retain highly skilled and motivated colleagues, a key aim of the NHS LTP workforce strategy.
In conclusion, nearly all of the improvements to health over the centuries have been a direct result of the adoption of advances in research and innovation, and therefore, growing our capabilities in research, innovation and improvement as a health and social care system is a must-do, not a nice to have. I am delighted that HNY ICB has made such a strong commitment to innovation with the launch of IRIS.
For further information about HNY IRIS, please contact hnyicb-ery.iris@nhs.net.