How NHS challenges are driving an innovation revolution

The NHS is beset with problems. However, these challenges could have an upside, driving a wave of staff ingenuity in everything from hygiene to treatment


Chelsea and Westminster hospital

Critics fear the NHS is straining, weighed under by the pandemic and soaring demand. These pressures are very real – but they’re also fuelling innovation. 

Faced with incessant challenges, everyone from cleaners to consultants are examining ways of improving the service. Bright ideas from hard-pressed staff are now revolutionising healthcare delivery, with staff deploying ingenuity and invention to solve problems. Welcome to the NHS’s innovation revolution.

The NHS deals with more than 1 million patients every 36 hours. Its 1.5 million staff face a treadmill of demand, including 16.25 million hospital admissions and 23.3 million accident and emergency unit attendances every year.

But against a backdrop of rising service demand and tightened finances, they’re devising hundreds of innovations. These range from workflow tweaks to treatment breakthroughs that are transforming care and improving efficiencies.

Lifting the load

Despite the frenetic pace of daily NHS life – intensified by the pandemic – the health system has created a progressive culture of change. Staff are encouraged to come up with ideas, then offered support to scale and grow projects.

Hospitals around the country are benefitting from such initiatives, including a one-stop prostate cancer clinic, an artificial intelligence (AI) system that speeds up diagnoses and an app that minimises maintenance issues that can hamper surgery. A group of hospital domestic staff also devised a better way of using cleaning fluids to improve hygiene and save money.

The bright ideas are curated by the NHS Innovation Accelerator (NIA), which promotes and guides promising initiatives through the health system’s bureaucracy so they can

deliver benefits to patients. Over the last six years it has helped raise £188m in external funding for innovations that are now used at 2,718 NHS sites and have saved the health service more than £40m.

“Who is better to create solutions than the people who work in the NHS every day and see where the problems are?” says NIA interim deputy director Maria Kyriacou. “These innovations show that the NHS and the people who work in it are doing everything they can to help the nation’s health.”

We have to innovate our way out of the pandemic by working in a different, smarter way

Individuals are coming forward with fresh ideas and smarter, more efficient ways of dealing with issues, Kyriacou says, “and they are getting results. It is lifting the load off everyone in a system that is already working so hard.”

Orthopaedic surgeon Ash Kalraiya founded MediShout through the NIA, developing a digital platform for clinicians to report problems and use AI to predict future issues. The idea came after he was forced to cancel three operations due to a broken lightbulb in the operating theatre and delay another because he had to fix a faulty printer at a London hospital. 

“It allows hospitals to resolve the small logistical problems that have huge consequences for staff and patients,” adds Kyriacou. “It is saving £1m a year in efficiencies and is now being rolled out at some of the largest UK hospitals. It’s just one example of the creativity and solution-based focus NHS staff possess.”

Innovation pathways

NIA’s support includes mentoring and learning programmes. There are also networking opportunities, helping to get innovations adopted across the NHS’s complex structure of 207 clinical commissioning groups, 206 health trusts and 1,229 hospitals around the UK.

There are routes through this crowded and often disjointed market, signposted by 15 regional Academic Health Science Networks (AHSNs), which connect the NHS, academic institutions, local authorities and charities. The network is hosted by the innovation catalyst UCLPartners, which also acts as a mediator between NHS and industry.

The aim is to spot innovations that can impact the health and care system, helping to scale them up across the NHS to become businesses. In 2020-21 it supported 2,888 companies and leveraged £462m of investment while creating 700 jobs and safeguarding 763 others.

“We have to innovate our way out of the pandemic by working in a different, smarter way,” says Professor Gary Ford, chair of the AHSN Network and chief executive officer of Oxford AHSN. “NHS innovation is often focused on the way we work and using approaches like digital tools to transform care pathways to meet the needs of patients. The people that best understand those needs work in the NHS.” 

While many parts of the health service are good at supporting people to develop their ideas within their own unit, the challenge is spreading this around the NHS, says Ford. This is why AHSNs were created. 

“We provide the right environment for innovators to work in the NHS and develop their ideas and curate them so they can be adopted more broadly.”

Entrepreneurial teams

London’s Chelsea and Westminster Hospital NHS Foundation Trust collaborates with its charity CW+ to run the CW Innovation programme, which tests and scales staff-led projects that improve patient care and hospital efficiencies.

It co-developed ISLA imaging technology, which remotely diagnoses rashes, wounds and skin conditions and has been rolled out across north-west London. The Trust also co-developed a real-time algorithm for Covid-19 patients, predicting their risk of ICU admission, the need for mechanical ventilation and in-hospital mortality.

“Digital innovation is front and centre at the Trust,” says Chris Chaney, chief executive of CW+. “Our internal infrastructure, entrepreneurial culture and growing partnerships with external organisations have all provided solid foundations for us to be able to respond quickly to the evolving needs of our patients and staff.”

Who is better to create solutions than the people who work in the NHS every day and see where the problems are?

The pandemic continues to put enormous pressure on the NHS, Chaney adds. More than ever, the service must embrace new ways to care for and treat patients as efficiently and effectively as possible. 

“One of our Trust’s values is ‘determined to develop’ and we are extremely proud of our entrepreneurial teams who have demonstrated just that and remain committed to maintaining momentum and driving a future of ongoing transformation not just at our Trust but across the NHS,” he says.

Efficiency boost

At Frimley Health NHS Trust, urology clinical specialist nurse Tanya Gill was instrumental in improving care for prostate cancer patients by creating a one-stop clinic. The 42-year-old noticed that patients often had to make repeat visits as they were processed through a slow, laborious system.

“Patients were waiting longer to find out if they did or did not have cancer and that is very distressing,” she says. “They were facing lots of visits with parking charges and invariably had to repeat what was wrong with them to a new clinician every time they came.”

With the backing of her line manager and consultant, Gill reworked procedures so patients could go from initial meeting through MRI scans and potential biopsies to diagnosis in one day, which has resulted in faster diagnosis rates and greater efficiency.

Consultant radiologist Dr Thomas Naunton Morgan devised Nighthawk – the out-of-hours radiology reporting system that provides diagnostics in peak periods – while working at West Middlesex University Hospital. He continued to develop AI systems, founding behold.ai, a company that has created an algorithm that can spot abnormalities in images, saving clinicians time and reducing backlogs.

Innovation from NHS staff is pumping through every artery of the health system. With waiting lists standing at 5.7 million and predicted to lengthen, the NHS needs its staff to maintain their dedication and ingenuity.