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NHS innovation is the key, says RAND report




Dr Sonja Marjanovic leads health innovation research at RAND Europe. Picture: Keith Heppell
Dr Sonja Marjanovic leads health innovation research at RAND Europe. Picture: Keith Heppell

Given the staffing crises and firefighting that is ongoing at the NHS it’s hard to imagine anyone has time to ponder the future, yet looking ahead is vital because the decisions being taken today will affect society for years if not decades to come.

A recent report by RAND Europe says that the NHS is going to have to do more with less. Squaring that circle won’t be easy, concludes the multi-year study – ‘Innovating for improved healthcare: policy and practice for a thriving NHS’ – which was funded by the Department of Health and Social Care Policy Research Programme.

The report’s lead author, South African-born Dr Sonja Marjanovic, leads health innovation research at RAND Europe. She studied genetics at the University of the Witwatersrand in Johannesburg: when working in a lab with antibiotic-resistant bacteria, she became interested in the social side of biomedical science. She first came to Cambridge to pursue a PhD Wellcome Trust-supported PhD at Cambridge Judge Business School, where she focused on innovation policy and international collaboration in biomedical and healthcare R&D.

“As in many other countries, the UK has an ageing population, a growing burden of chronic disease and a changing nature of demand for health services,” says Sonja. “The NHS is under pressure to transform and find more sustainable ways of operating.”

Conducted between 2015 until early 2019, RAND found that although government policy initiatives are gradually helping to support a more innovative healthcare system, staff still often lack the appropriate skills, incentives, resources, infrastructure and accountabilities to effectively engage with innovation.

“In order for a truly innovative healthcare system to thrive, we also need culture change in the NHS,” she says. “Not everyone in the NHS needs to be an innovator or a clinical entrepreneur,nor would that ever be feasible nor necessarily desirable, but more people need to be trained and enabled to understand what innovation is about, what impact it can have on patients and on the workforce, and what opportunities are out there.

“Innovation is still seen more as a ‘nice-to-have’ than a ‘must-have’ in many parts of the NHS.”

Changing the culture at a large organisation requires contributions from those who understand its mentality, and fortunately there are such organisations in the region - Health Enterprise East (HEE), Medovate and the Academic Health Science Network (AHSN), for example.

Networks such as the AHSN are helping raise awareness and broker information and contacts.

Robot surgery with Versius in an NHS operating theatre. Picture: CMR Surgical
Robot surgery with Versius in an NHS operating theatre. Picture: CMR Surgical

Piers Ricketts, chief executive officer at Eastern AHSN, said: “Eastern AHSN is part of a national, publicly-funded network whose role is to support the best innovations in health and care and to accelerate their delivery into the NHS for the benefit of our region’s citizens and patients.

“We agree with many of the report’s conclusions. The NHS is a huge and complex system, but the Department for Health and Social Care has done much over the last three years to support the drive for the NHS to get better at adopting new solutions and technologies.

“Our own work at Eastern AHSN has resulted in many tangible benefits to patients and citizens. For example, we have helped to reduce the number of strokes due to atrial fibrillation, reduced the risks of premature babies being born with cerebral palsy and introduced technology to support GPs in their prescribing decisions.

“We are privileged to work in one the world’s outstanding regions for discovery in health and life sciences, and we have exciting plans to accelerate the pace at which these discoveries get adopted into our health and care system.”

Meanwhile Anne Blackwood, chief executive of Health Enterprise East, says: “This is a really useful piece of research that gives evidence of the barriers for innovation in the NHS, both for internal innovators as well as companies trying to get their products adopted.

Medovate managing director Stuart Thomson with right Dr Anne Blackwood, CEO of Health Enterprise East. Picture: Keith Heppell
Medovate managing director Stuart Thomson with right Dr Anne Blackwood, CEO of Health Enterprise East. Picture: Keith Heppell

“To allow this research to have the maximum impact it has potential for, it will require leadership, resources and accountability – and there is not really any one place where this sits in the healthcare system. While there are positive initiatives taking place already, we’re facing a fragmented system that means the pace and scale of change isn’t where it needs to be.

“As the report identifies, there are currently no standardised metrics for innovation in place that trusts can refer to or compare against, nor any standard methods for evaluating the impact of innovation, so it’s not surprising that adoption of new medical technology is slow.

“We need to see more incentives and levers that will encourage widespread adoption and bring about the positive change that innovation will allow.”

Medovate, which spun out of HEE to commercialise medical devices, has launched two products recently: SAFIRA offers safer anaesthetic procedures, and ENDOVAC has the potential to dramatically improve survival of patients with life threatening infection following a leak from their the upper gastrointestinal (GI) tract.

“Our partnership with HEE means we can look at various technologies and negotiate a deal working with the NHS, HEE and our two investors,” says Medovate managing director Stuart Thompson.

Looks like finding a way to work together has to be the way ahead for the NHS - and coronavirus has only accelerated that process.



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