Innovation Management Tasks Innovation Toolkit · PDF fileInnovation Management A guide to using the Innovation Toolkit • Working with your strengths • Supporting your new company

Innovation Management

A guide to using the Innovation Toolkit

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About 2Bio 2Bio Ltd was established as a company in 2007, its founding team having successfully delivered the MerseyBio programme in Liverpool, which developed innovations, IP and new businesses from local Merseyside partners, including the NHS trusts, the universities and independent innovators.

2Bio Ltd is a private, Liverpool-based company that provides expertise in developing and managing innovation, across the healthcare and life science sectors. 2Bio also supports organisations to manage their intellectual property and to commercialise early-stage technologies.

2Bio has built on this success, working with clients who require strategic advice to develop their innovation strategies, optimise their R&D outputs, commercialise intellectual property and grow businesses in the Life Sciences and Healthcare sector. 2Bio is now working with a number of NHS trusts in the Merseyside region, including the Royal Liverpool & Broadgreen University Hospitals NHS Trust.

2Bio’s Healthcare Innovation team works with hospitals and research organisations to initially develop their ability to manage innovation and then where required embed themselves within the culture of the organisation; engaging with innovators to identify and appraise new ideas, supporting development of plans to test and implement good ideas and then sharing the outcomes with management and other organisations.

Contact Details Dr Charley Ward Senior Business Consultant 2Bio Ltd Tel: 0151 7954100 Email: [email protected]

Innovation ToolKit

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About the Innovation ToolKit The Regional Innovation Fund supported the Walton Centre NHS Foundation Trust to develop an Innovation Toolkit to assist NHS Trusts across the North West Coast Academic Health Science Network to better develop an innovative culture within their organisation.

This project was conceived as a result of an Innovation Workshop held by The Walton Centre NHS Foundation Trust in collaboration with the North West Coast Academic Health Science Network, to which innovation leads, R&D managers and clinicians from across the North West were invited. Many individuals at that workshop indicated that they were keen to support innovation but were unsure how best to start. This initiative aimed to assist Innovation Managers to embed innovation as core business in their organisation; enabling them to provide frontline staff with the skills to understand the relevance of innovation how they can play a vital role in identifying or championing bright ideas developed internally or imported from elsewhere that result in tangible benefits for patients.

The Walton Centre NHS Foundation Trust has worked with 2Bio Ltd and OurLife to develop and test this Innovation Toolkit that will enable NHS Trusts to embed innovation as core trust business and support trusts in delivering against innovation objectives. The Innovation Toolkit that has been developed has been tested by a number of NHS Trusts including:

• Liverpool Community Health NHS Trust,

• Cheshire & Wirral Partnership NHS Foundation Trust,

• Southport & Ormskirk Hospital NHS Trust,

• Countess of Chester Hospital NHS Foundation Trust,

• St Helens & Knowsley NHS Trust,

• Lancashire Care NHS Foundation Trust and

• Clatterbridge Cancer Centre NHS Foundation Trust,

to establish that the ToolKit is suitable for use across a range of healthcare settings including acutes trusts and community trusts.

This final Innovation ToolKit is intended to be rolled out across the North West Academic Health Science Network.

In developing this Innovation ToolKit the project team initially sought to determine what Tools should be prioritised for development, by performing a brief survey of a small panel of Trusts designed to understand how 'Innovation Ready' NHS organisations are in the local area, and how well equipped they are to manage, support and promote an innovative culture. The survey was pitched towards Innovation Managers within Trusts who are responsible for engaging with and delivering support to innovators within their organisation. The Innovation Managers were asked questions regarding their perception of the innovation culture within their organisation and to determine what tools they currently have available to them. Following this survey, the findings were shared with these Trusts and a menu of potential Tools presented for discussion. This final ToolKit has been developed as a consequence of those discussions.

All of the tools in the Innovation ToolKit can be downloaded from the website that has been established for this project https://nhsinnovationtoolkit.wordpress.com/ .

Innovation ToolKit ! of !3 22

https://nhsinnovationtoolkit.wordpress.com/

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Introduction to Innovation Innovation is...

‘An idea, service or product, new to the NHS or applied in a way that is new to the NHS, which significantly improves the quality of health and care wherever it is applied.’ - Innovation, Health and Wealth.

Innovation activity plays a key role in delivering healthcare benefits to the NHS, as well as providing routes to improving efficiency and productivity. Supporting innovation therefore is a high priority for the NHS Trusts as it can potentially support in delivering on local and national targets that impact upon each organisation in terms of incentives, penalties and quality of patient care. Many NHS Trusts have made a strategic commitment to embracing a culture of innovation and continuous quality improvement in line with goals set out in the Innovation, Health and Wealth paper (Accelerating Adoption and Diffusion in the NHS) published in 2011. In order for Trusts to deliver this commitment, it is necessary to provide a suitable framework of support, working under a clear innovation strategy.

Drivers for Supporting Innovation Activity There are many reasons why NHS Trusts should seek to effectively support innovation activity at their organisation.

Trust Obligations Firstly, NHS Trusts are required to support innovation. Improving services via innovation is pledged by NHS staff under the NHS Constitution and mandated in the Health and Social care act 2012;

‘All NHS organisations and local authorities work to improve the quality of the services they provide or commission, including by assessing clinical and service innovations relevant to their clinical responsibilities.’ - NHS Constitution

‘Duty to promote innovation - The Board must, in the exercise of its functions, promote innovation in the provision of health services...’ - Health and Social Care Act 2012

Furthermore, NHS Trusts that are in receipt of certain funding streams may also be obliged to disseminate results and outcomes from funded projects in relation to new technologies and innovations.

Incentives and Return on Investment Developing and implementing innovations that positively create benefits for patients can also potentially save money for NHS Trusts, which are incentives in themselves. However there are many other potential returns on investment and incentives that will be required to be communicated under an innovation support framework to:

• motivate Clinical Directorates and Trust staff to become involved in innovation if they haven’t before, or

• if they are already involved in innovation locally, to continue to drive the adoption and diffusion of innovations outside of the organisation

Key incentives and drivers that important to communicate and which should steer development of an innovation support framework are described in more detail below:


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Financial Incentives A major financial incentive to innovate is the potential for Trust’s to benefit from quality-based payments, to avoid penalties received as a consequence of breach of national targets and to potentially generate income. Examples of areas where innovation may impact upon financial returns include:

• Penalties for locally-agreed hospital-acquired infection targets e.g. cases of Clostridium difficile infection above agreed target rates, or non-payment of new costs associated with patients admitted as an emergency within 30 days of discharge by a Trust.

• Commissioning for Quality and Innovation (CQUIN) Payments - Clinical Commissioning Groups (CCGs) locally agree with the Trusts a number of services to be part of the local CQUIN scheme, where providers of these services are entitled to additional payments if they meet specific targets. Examples of CQUIN targets include improvement of discharge planning and follow-up of cancer patients after the acute treatment phase and to improve performance against the 62-day cancer waiting times standard from urgent suspected cancer referral to first definitive treatment.

• Commercialisation - although less common, some innovations can lead to the development and commercialisation of a product which can provide income (in the form of licence income) for a Trust (which may be shared with the Inventors according to local policy).

Reputational Benefits An additional potential benefit of innovation activity includes raising the profile and enhancing the reputation of a Trust, and its staff, and ensuring recognition for examples of best practice. An important feature of an innovation support framework will be to support the dissemination of successful innovations to ensure that NHS Trusts are diffusing high quality innovations throughout NHS England.

This dissemination process, will not only deliver innovations to whom they might be useful, it should also provide Innovators with a means of formally assessing the impact of the innovation in terms of economic benefits and/or patient benefit/satisfaction. For example, well-developed innovations can be submitted as case studies into the Quality & Productivity Case Studies (previously known as QIPP) system which then undergo a process of validation and accreditation. Validated innovations are then disseminated out via the NICE evidence system for adoption by other Trusts.

Cultural Barriers Unlocking the benefits of innovation is significantly challenging. For instance, innovations can be difficult to identify as staff who are not ‘innovation-aware’ may not recognise that they are being innovative and therefore do not disseminate their developments to their colleagues or those responsible for innovation management. As a consequence innovative approaches may not be adopted elsewhere in a Trust or be available to share with other NHS Trusts. An inability to recognise, develop and implement innovations means that opportunities to improve patient care across the organisation (and across the NHS) may be lost. From a commercial and global perspective a failure to recognise innovations that have intellectual property associated with them may result in lost opportunities to deliver new healthcare products and services, to generate income and to contribute to the UK economy through new business creation in the healthcare sector. Even if innovations are identified, there are many other barriers to their development, dissemination and adoption including, for example, the availability of development funding, support for engagement with companies, support for adoption of innovations and the complexities around commercial arrangements or 3rd party intellectual property.


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The purpose of an innovation support framework therefore should be to seek to lower these barriers; making it easier for Innovators to be more aware of how to recognise and develop their ideas, and to provide support for Innovators to enter uncharted territories through mentoring and networking.

The next section of this guide describes the processes that are required to be supported during the typically pathway of innovation.


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Innovation Pathway The NHS innovation landscape is complex, with multiple initiatives designed to promote innovation activity, many different incentive schemes and a range of organisations that can provide support or who have an interest in innovation outcomes. The landscape was made even more confusing when the NHS restructured in April 2013, resulting in information on a mix of old and new initiatives (and websites) still being available. It is recognised that, as a consequence, Innovation Mangers may be unclear regarding what external support is available and how they may be required to support innovation projects. In the first instance therefore we have developed an understanding of the typical innovation pathway, around which an Innovation support framework can be designed. This Innovation Pathway is shown in Figure 1.

Fig 1. Typical innovation pathway

The innovation pathway includes the following steps:

• Recognise Issue - This requires identification of a ‘problem’ with a particular service, care pathway or system at the organisation This can include clinical and organisational issues. This stage of the process requires innovators to describe the problem and what the consequences are, to consider the causes of the problem and to have awareness of the baseline metrics around the problem e.g. number of patients it affects, breach of target rate, number of bed days.

• Find Solution - This requires the innovators to identify a solution to the ‘problem’. This may involve de novo development of a solution (e.g. by redesigning a care pathway to eliminate the cause of a problem), review of formal guidance (e.g. NICE) and validated innovations (e.g. from Quality & Productivity Case Studies), appraisal of a new technology or product, or even seeking inspiration from (unvalidated) examples at other Trusts (e.g. from NHS England Innovation Exchange). Appraisal of potential solutions will involve assessment of the potential clinical, organisational and/or cost benefits of the solutions, as well as an assessment of the feasibility of implementing the solution. At this stage it will also be important to consider which departments and individuals may be affected by the proposed solution e.g. introduction of a new in vitro diagnostic by a clinical department may improve patient outcomes, but will also also have an impact


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upon the diagnostic laboratories who may have to assume the cost of purchasing new kits, require new equipment, require an assay validation process and have to potentially train staff up.

• Development - Some innovations, particularly new and unvalidated innovations and those that are technology-based, are likely to require a period of further research and development. This may involve prototyping, proof of concept or feasibility testing and may require additional financial resource to be obtained from external sources. The length of this development phase will vary greatly depending upon the nature of innovation, and may even have regulatory considerations e.g. clinical trial approvals.

• Test Solution - Once a suitable innovation solution has been identified, appraised and potentially some development work undertaken, there will be a need to locally test the beneficial impact of that innovation and to demonstrate feasibility of implementation. To be able to effectively test the solution will require the lead innovator to communicate the benefits and issues associated with the innovation to all those at the Trust who will be affected and to obtain their support for its evaluation. There may be phases to this testing e.g. an initial pilot study may be planned to support implementation by identifying any issues, followed by a more extensive evaluation.

• Adoption

• Evaluation - Following testing there is a need to assess the impact of implementing the innovation in terms of the effect on patient benefits, targets, cost or organisational benefits. The nature of the measurables will be determined by the type of innovation and the nature of the problem and for example may include:

• enhanced feedback on patient experience and satisfaction

• patient safety improvements

• quality of care enhancements

• improved clinical outcomes

• cost effectiveness

• prevention of disease, incidents or harm

• improvements in health of the local population

• improvements staff productivity

• improved discharge timelines

• reduced readmission rates

• At the outset of each innovation project, there will be requirement to identify suitable measures that can be used to determine if the project has successfully achieved its goals. The selection of these measurables also needs to be performed with consideration for the overall strategic objectives and targets of the Trust.

• Diffusion - Diffusion refers to the sharing of the innovation, the means to implement the idea and evidence of its benefits across the wider organisation (if appropriate) and the NHS. Dissemination of good innovation case studies may be performed through: collaborative relationships e.g. directly with other Trusts, or through regional partnerships such as the Academic Health Sciences Network; through formal channels e.g. a Quality & Productivity Series Case Study which would be subjected to stringent review and appraisal; through peer review processes e.g. the NHS England Innovation Exchange; or through public engagement mechanisms e.g. media outlets.


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In the next sections of this guide we provide further detail on the key elements required to be in place as part of an effective innovation support framework and the key tasks that are required to be undertaken by an Innovation Support team.


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Support Framework Supporting innovation activity at an organisation is reliant upon building a network of support, to assist innovators in leading and managing their projects. An innovation support framework is not intended to innovate itself nor drive projects without participation of the Innovator; innovation projects must be driven by those who have the good idea or who wish to make a change within their area of responsibility. An innovation support framework can help Innovators to achieve their goals, supporting them to develop their idea, engage with their colleagues to make changes and to provide a governance framework under which they can effectively work. It is expected that an innovation support framework would comprise the following elements:

Innovation Support Team For a small Trust this may comprise a single member of staff that functions as an Innovation Manager; for larger Trusts this may involve a team of individuals or even draw upon existing staff in allied areas e.g. Research & Development support staff. Some Trusts have even elected to outsource provision of support services; contracting in outside expertise for specific activities.

The main role of the Innovation Support team is to provide hands on support to innovation projects and to manage the innovation portfolio. The Innovation Support team should act as the central management and coordination point for innovation activity at an organisation. The activities undertaken by the Innovation Support team should be aimed at:

• driving a change in culture around innovation activity at the Trust

• supporting Trust staff to develop, test and implement innovations which can create improvements in quality, efficiency and effectiveness of healthcare services at the Trust

• identifying problems and issues faced by the Trust which innovations may be able to address

• identifying and evaluating innovations that solve problems at the Trust and in the wider NHS

• reporting progress and outcomes of innovation activity as required for national and local reports

• working with and complementing existing support and initiatives e.g. service improvement activities

Specific tasks and responsibilities of the Innovation Support Team should include:

• development and delivery of training events, workshops and networking events to stimulate interest in innovation and to provide opportunities to enhance understanding of innovation and to identify new innovation projects. This will involve development of suitable training material, event agendas, event marketing materials, and of a contact database.

• delivery on a communications strategy around innovation activity, available support and project outcomes to internal and external audiences. This will involve maintenance of a contact database, development of communication documents including background material to improve understanding as well as case studies and news stories.

• engagement with staff of all levels to identify innovation projects and to disseminate new innovation opportunities to staff. This will involve regular face-to-face discussions with staff to derive an understanding of clinical, organisational, regulatory and financial issues, to have technical and clinically-based discussions around innovations, and to communicate the details of externally-derived innovations to staff.


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• evaluation of new innovation opportunities to determine what support may be required in terms of development, intellectual property protection, funding, testing and implementation, business case development and routes to adoption and diffusion. Following on from evaluation there will be a need to develop a written plan to support the project and to present this plan to the trust.

• identify funding schemes that may support development, testing and adoption of new innovations, raise awareness of such funding to staff and support innovators to apply for funding.

• support the implementation of development plans of innovations where there may not yet be validated evidence of clinical-effectiveness. This will require support to be provided to innovators in terms of generating a development plan (mindful of the regulatory environment and with consideration to the Innovation Pathway) accessing funding, engaging and negotiating with commercial providers and partners, development of agreements, monitoring of the project in terms of progress against milestones and reporting of outcomes.

• development of an innovation network that includes innovators, clinicians, researchers, companies, other support organisations e.g. North West Coast Academic Health Science Network, funders, commissioners of health care, regulatory agencies. The ability to access suitable representatives in these organisations will be essential in this role.

• managerial responsibility for registration and effective management of all innovation projects through the organisation. This will require maintenance of a project database and effective record-keeping for all innovation projects.

• ensuring that comprehensive management information is obtained and analysed during the conduct of innovation engagement. This will require engagement with innovators and Innovation Champions, to capture data relating to the level of innovation activity, project progress and outcomes, identification of potential case studies, reporting of this information to the organisation

Further detail of the tasks required to undertaken is provided in the ‘Operational Support’ section of this guide. .

Innovation Champions Better engagement with staff can be achieved through building of an internal network of individuals who have an interest in innovation, and that also understand the clinical and service-delivery issues that departments and specialities face. Such individuals can act as a champion for innovation within their department or team and can serve as useful point of contact for communication between the Innovation Support Team, staff and potential innovators.

Within each department or team, an Innovation Champion is recommended to be appointed to have the following responsibilities:

• to act as the primary point of contact between your department and the Innovation Support Team; helping to circulate information e.g. funding calls, to make introductions between staff and the Innovation Support Team.

• to promote and encourage innovation activity within their department; inviting staff within your department to discuss their own ideas or plans to adopt an externally developed innovation, support efforts to educate staff in innovation

• to highlight projects to the Innovation Support Team, so that these can be evaluated to establish the support required for their development or implementation..


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• to assist the Innovation Support Team to appraise externally sourced ideas, by providing opinion on the potential clinical benefits and the likely feasibility of implementing locally.

• to meet with the Innovation Support Team at suitable intervals to discuss innovation activity within your department, so that information can be gathered to enable the Innovation Support team to report on innovation activity to Trust management teams and to any external organisations as required e.g. Department of Health, via the annual Trust report dashboards.

• to assist innovators in each department to facilitate cross-departmental co-operation for the development or adoption of an innovation idea

• to support development of the organisation’s innovation strategy, by highlighting relevant issues faced by your department or clinical speciality

In return for this commitment, departments will benefit directly from rapid access to the Innovation Support Team, access to information on new ideas and innovations which may improve department performance, access to information on funding which can support development and adoption of innovations, support with applying for funding, support for developing ideas, opportunities to undertake training and acquire new knowledge as well as the ability to bring about culture change which will make the process of identifying, developing and adopting new ideas much more reliable.

Network of Support It is highly likely that in most organisation there are a number of teams already in place who currently come into contact with and support innovation projects and who are likely to have an interest in the outcomes from innovation activity. These teams may not be fully aware that the work they undertake has any relationship with innovation activity.

An innovation support framework needs to be designed so as not to have a negative impact upon the way in which these teams currently deliver support, and that simply enables the Innovation Support team to work in partnership with these teams and to add additional expertise and resource where required. Examples of such teams common to many NHS Trusts include:

Service Improvement or Quality Improvement Team - such teams predominantly support the redevelopment and adoption of improved care pathways and care bundles. Often the redesign of pathways can take an innovative approach and likewise such teams may be able to benefit from a review of the external landscape to identify ideas which may have been tested and validated elsewhere.

Information Management and Technology Systems Team - these teams are frequently engaged in supporting the development of innovative ideas, often being asked to develop a new system to underpin a change in the process or to create efficiencies and productivity gains. Such innovation projects may have commercial potential. However, IM&T teams are often in high demand for support and so an effective means of working together needs to be established to avoid the risk that increased engagement around innovation projects increases demand further for IM&T support.


THE INNOVATION TOOLKIT CONTAINS:

• INNOVATION CHAMPION ROLE DESCRIPTION

WHICH MAY BE USED TO APPOINT INDIVIDUALS TO THIS POSITION.

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Cost Improvement Programs - these teams are required to identify and support implementation of ideas which can create efficiencies, reduce costs and potentially create new income opportunities. Such teams would have a vested interest in supporting innovation activity and can be a useful source of intelligence regarding measurement of benefits arising from an innovation project.

Clinical Audit - audit teams are responsible for collation and reporting of clinical data and analyses. Such intelligence can be highly valuable when appraising a potential idea or to capture benefits achieved through implementation of an innovative idea.

By taking a corporate approach the Innovation Support Team can avoid the risk of working in a silo, and can access additional resource by focusing upon high priority strategic areas for the organisation.


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Operational Support In this section we provide further detail on the day-to-day tasks that are required to be undertaken by the Innovation Support Team to effectively support innovation culture and activity within their organisation. These tasks are described with reference to the Innovation Pathway below. Where relevant we have highlighted (in orange boxes) which Innovation Tools are available to support the activities described.

Recognising the Issue and Identifying a Solution Identifying services, care pathways or systems that could be improved, and finding solutions, is the start of the Innovation Pathway. Innovation is happening all the time at most organisations but many innovators are unaware that they are being innovative and organisations often fail to capture those projects. It is the purpose of the Innovation Support team to capture innovative ideas and to support the development and implementation of those projects. The Innovation Support team is also required to have an outward-facing role; to raise awareness of local and national issues that could be addressed with innovative ideas and to identify externally developed innovations that could address local issues. To support awareness raising, and to identify ‘problems’ the following activities are required to be performed:

Staff Engagement and Training Programme In launching an Innovation Support Framework there is a need to develop both background information (about the support available and some key definitions and examples) and a programme of staff engagement and training, that seeks to complement existing programmes (of staff engagement and training). In the early phase of staff engagement, it is recommended that the main focus should be on making an introduction to innovation; to provide definitions around innovation, to highlight the support at the organisation, to dispel some myths around innovation activity and to clarify where IP and commercial activity sits within the innovation framework (there is often some confusion around the definition of innovation and the incorrect assumption that it only involves technologies and commercial opportunities).


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There is also a need to engage with staff to understand what barriers to engaging in innovation activity exist, and to identify problems and issues that are faced on the front-line in delivery of healthcare services. Later on, more in-depth engagement (downstream) is recommended to focus upon appraisal of new innovations and possible solutions to issues and problems faced by the organisation. Such engagement may take the form of workshops or individual meetings. Tasks required will include development of training materials, development of agendas and papers for meetings and workshops.

The Innovation Support Team will need to maintain innovation awareness of nationally and locally identified high priority areas and disseminate this information via its staff engagement program. There will also be a need to communicate innovation case studies to exemplify different types of innovation and help staff recognise situations where innovation could help to solve identified issues or improve services.

Identification of Solutions There is a potential wealth of innovative ideas generated at each NHS Trust which may address local and/or national issues and, which the Innovation Support Team should aim to identify, appraise and support through its Innovation Support Framework. The Innovation Support Team may capture innovation projects through the following activities:

• Proactive engagement with Trust Staff

• Events/Seminars/Workshops - we expect people to stay after events to talk or contact us shortly after the event - found to be the most effective form of proactive communication in the past

• Direct meetings with Trust staff encouraged by the Innovation Champions

• Reactive responses to enquires directly to the Innovation Support team

• Interactions with allied support services e.g. Service Improvement Team

There are also a wealth of innovative ideas available from the outside world, however each Trust will need to agree a strategy for appraising those innovations that align to the strategic objectives of their organisation and which can address real needs and problems at their Trust. Some of these innovations may be identified through dedicated information portals and documents such as the NHS England Innovation Exchange or through the Quality & Productivity Case Studies.


THE INNOVATION TOOKIT CONTAINS:

• ’INTRODUCTION TO INNOVATION’ PRESENTATION,

• STAFF SURVEY

• WORKSHOP TEMPLATE

• MENU OF USEFUL INNOVATION RESOURCES

• CASE STUDIES

TO SUPPORT STAFF ENGAGEMENT AND TRAINING

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If the externally-developed Innovation is considered to have potential to deliver benefits locally then it will be communicated to departments or clinical leads to whom it might be relevant. However, it should be emphasised that even though an external idea might have potential benefits, it will not be possible to adopt without a clinical lead to champion the innovation i.e. a Project Owner, in these cases the Innovation Support Team would not be able to support further progression through the Innovation Pathway.

There will also be a need to communicate opportunities for the organisation to provide a test bed for new technologies and innovations.

Appraisal of Innovative Solutions Once solutions are identified there is a need for a process of appraisal to establish which innovations should be supported in terms of development, adoption and diffusion. In the case of innovations adopted from outside the organisation it is likely that the Innovation Support Team will have performed some preliminary assessment of their utility prior to the appraisal process and therefore some of the appraisal questions may already have been considered. However, the appraisal process will still need to be undertaken to understand what plans the Innovation Lead has to test and adopt the innovation, and to understand what support may be required.

The ‘type’ of innovation to be appraised may determine which teams support the process. For example, care pathway issues may be best appraised by a Service Improvement Team using their existing processes. The appraisal of innovations that may have an impact across the whole organisation may be best carried out by the Cost Improvement Programme team. IT-driven innovations are likely to require appraisal support from the local Information Management & Technology team. For device-based innovations (typically approved products or those with a high degree of clinical validation) there is likely to be a need to engage with the local devices evaluation group. A local process needs to be developed whereby a network of departments and teams who have an interest in the outcomes of innovation or a remit to already support certain activities is engaged, and provided with a good understanding of the goals of the Innovation Support Framework. This will enable a clear process to be developed whereby the most appropriate team is engaged to support project appraisal and subsequent development. The process is also required to facilitate collaboration of more than one team if a particular innovation project requires a broader range of expertise. By engaging these teams at the outset, the task of obtaining support is made easier and teams begin to develop a stronger understanding regarding what projects are appropriate for support and what resource and capacity constraints may exist.

Innovator Meeting For each innovation opportunity, an operational member of the Innovation Support Team would arrange an appointment to meet with the Innovator to discuss the idea. The team will use appropriate tools to capture the



• MENU OF EXTERNAL SOURCES OF INNOVATION

TO SUPPORT IDENTIFICATION OF SOLUTIONS

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information to maximise the value of the meeting, so that staff time is not needlessly utilised. Such information capture tools will include questionnaires which seek to obtain the following information:

• Description of the innovation

• Was it developed in-house or has it sourced externally?

• Understand the clinical or healthcare need it addresses

• Understand how it will contribute to the improvement of health and care, and/or facilitate cost reductions

• Determine stage of development i.e. has it been tested? On what scale? Is there any evidence of the potential impact?

• What are the outcome measures of the innovation? What is the performance baseline at present?

The information gathered at the initial appointment should be used to compete an Innovation Record Form and will be added to the Innovation Portfolio database.

Maintenance of Innovation Portfolio Projects should be recorded in a suitable Innovation Portfolio database or spreadsheet, which will also detail the current stage of development and support the project has received. The database should be updated regularly and presented to the organisation via an agreed governance route. The portfolio database should document at a minimum:

• Project ID Number

• Name of the Innovation Lead

• Department

• Title of Project

• Status Update

• Team with overall responsibility for delivering support

• IP-related information, where appropriate

• Planned Tasks

• Potential Benefits and actual Delivered Benefits.

The Innovation Portfolio should be maintained as an internal confidential document.



• INNOVATION RECORDAL FORM

• INNOVATION PORTFOLIO SPREADSHEET TEMPLATE

TO SUPPORT IDENTIFICATION AND TRACKING OF INNOVATIVE SOLUTIONS

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Appraisal Appraisal of the innovation should address the following questions:

• What is the potential impact of addressing the need/problem?

• How well developed or validated is the innovation i.e. what evidence exists already in respect of the benefits of the innovation?

• Does the innovation have potential to deliver cost effectiveness?

• How scalable and implementable is the innovation? What are the costs associated with implementation?

• What barriers to adoption exist?

• Does the proposed innovation address a local issue, an NHS-wide issue or does it have global significance?

• Why would the organisation be encouraged to adopt the innovation (for externally developed innovations)?

• Why would other users be encouraged to adopt the innovation?

• Does the innovation have commercial potential? If so, then downstream strategy will need to involve intellectual property and commercial support.

• How motivated is the Innovator to develop the innovation and to support the adoption strategy.

Appraisal of the innovation would need to be performed by the Innovation Support Team with reference to the external world and the ‘market’ for the innovation. If the innovation is considered to have potential to deliver benefits locally and wider then it will be adopted into the Innovation Portfolio for further support. If the organisation considers that a proposed innovation has significant issues or there is an obvious lack of benefit, then feedback will be provided to the Innovator to explain why the project cannot be actively supported by the organisation at that time. The organisation in many cases may elect to monitor the project and revisit the project at a suitable interval.

Development & Testing Once an innovation has been appraised by the Innovation Support Team, and it has been agreed the innovation will be supported, the next stage will be to put the solution into practice. By piloting the innovation in a test environment, such as a single department, Trust or local region, Innovators will be able to assess the impact of the innovation and understand the process of implementation, and this knowledge can then be disseminated to other departments or other Trusts in the region.



• INNOVATION SUPPORT GUIDE

TO SUPPORT DECISION MAKING IN MANAGING AN INNOVATION PROJECT

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This part of the innovation pathway will require a number of activities to be undertaken by the Innovator and Innovation Leads, including acquiring funding to support costs that will be incurred through implementing the innovation, obtaining support from the relevant departments or other Trusts, and, if the innovation is successful, collecting and compiling the relevant data and evidence.

Development For innovation projects that involve early stage innovations (i.e. un-tested technologies or ideas) the project may require further research and development (R&D) to be conducted to obtain some proof of concept data, for example. In this case the Innovation Support Team may be required to support the Innovator with aspects of the development and execution of an R&D plan.

Some innovation projects may have associated IP and commercial feasibility and therefore require additional support in respect of development of an IP protection strategy and commercialisation plan. In this case a development plan that outlines required development steps and identifies key commercial development milestones will need to be produced, that takes into consideration of the IP strategy and the commercialisation strategy (developed by the local IP management team). The development plans will need to be properly costed and potential sources of funding identified where possible.

Even for those innovation projects which do not have any associated IP or a potential global market, a plan may still be required which outlines R&D plans and timelines indicating how the innovation will be developed to a point where it can be implemented and what funding or resource is required.

Funding Support Developing, testing and implementing innovations can take various lengths of time depending on the nature of solution or technology. Funding may be required to support costs such as pure research, materials, administrative costs and human resource.

While the completion and submission of funding applications remain the responsibility of the Innovator the Innovation Support Team will be required to support this process. A strategy for monitoring and communicating new funding opportunities may need to be developed and projects actively targeted for support.

Departmental Support Implementing new technologies and processes can, in the first instance, result in a degree of upheaval and disruption before the benefits are realised. Furthermore, some innovations require changes to be made to care pathways or systems that effect multiple Trusts and other care providers e.g. GPs. Therefore, an important part of the innovation pathway will be for Innovators to ensure that plans are effectively communicated to those



• MENU OF INNOVATION FUNDING OPPORTUNITIES

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involved in the implementation of the innovation and also to those who will be affected by the innovation (i.e. staff, patients, other external healthcare professionals).

The Innovation Support Team and the Innovation Champions will be required to facilitate and support Innovators in interactions with the relevant departmental managers to obtain support for the implementation of an innovation. Depending on the scale of the innovation it may also require the support of other departments, the Trust Board, and possibly the local CCG, if payment contracts and protocols need to be changed.

Adoption Following testing or piloting of an idea, and on the basis of there being an initial indication of measurable benefits being achieved, it is likely that the decision will be made to roll-out the innovation more widely. In many situations, a business case (of varying detail and length) may have to be presented.

Business Case A written business case is required whenever resource or expenditure on a project has to be justified, and approval from another party is required to undertake that project. A business case may also be necessary if implementation of the innovation requires a number of local Trusts to participate.

A business case is a proposal seeking authorisation for the allocation of resource associated with change to the business e.g. to bid to provide new services, to purchase new services, to use capital or revenue to acquire or develop something. It includes all relevant factors and tells people about the what, when, where, how and why of the proposed project.

• Why is the project needed (issues & opportunities)?

• What is the recommended solution(s)?

• How does the solution address the issues or opportunities (benefits)?

• What will happen to the business in a ‘do nothing’ scenario?

• When will the solutions be deployed

• How much money, people, and time will be needed to deliver the solution and realise the benefits?

• The nature of the potential benefits, in terms of the value, scale and timelines.

Evaluation of Impact A member of the Innovation Support Team will be required to meet with Innovators on a regular basis to obtain updates on the implementation progress of an active innovation project and record any outcomes. The Innovation Support Team can then report back via the organisation’s governance process; progress will be recorded in the Innovation Portfolio database, and any evaluation-related actions required on the project can be delegated.

Reporting on the impact of an innovation will be a crucial part of the innovation pathway and will allow effective diffusion.

Measurement Outcomes Measurement outcomes for an innovation should be considered before a project is initiated (i.e. in the appraisal process) in order to understand the ‘baseline’ and so any improvements can be measured effectively. The types of measurement outcomes that can be used to assess the impact of an innovation will be quite diverse, some of which the teams will be familiar with and others that may require some specialist input from other Trust


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departments. For instance, measures such as patient emergency readmission rates or patient bed days are considered effective measures of impact of a pathway or service related innovation, however the precise economic value of these measures is more challenging to define. As part of the Innovation Support Framework, the Innovation Support Team will require a strategy of engaging other departments and teams such as the Finance Department or the Audit Team to identify suitable mechanisms for obtaining the information required to enable improved outcome measuring, as well as looking for examples of impact measurement from NHS literature or other case studies.

Feedback and Refinement After the innovation has been implemented locally, the Innovator will need to obtain some feedback about the innovation. Conducting interviews with colleagues or sending out questionnaires might be a way to get feedback on the innovation and help inform improvements on the innovation itself or how it is implemented, and can also be classed as an outcome measure.

Another useful tool to obtain a critique from a wider community is the NHS England Innovation Exchange. This portal, operated by Innovation, Health and Wealth (Quality Improvement), is intended to be used as a means of networking and sharing innovation ideas. Users can submit innovation ideas via the portal and other users can appraise the idea and make comments and suggestions. Although this activity is not a crucial step in the Innovation Pathway, it could provide an early indication of whether the innovation addresses issues outside of the local organisation and therefore how likely uptake might be in the Diffusion step of the Innovation Pathway.

Diffusion Diffusion of innovations is an important step in the Innovation Pathway as is the process by which others can benefit from the information gathered at the adoption stage and also where the organisation will realise the reputational benefits of engaging in innovation activity.

There are a number of potential routes of diffusion of an innovation, including;

• Publications - The results of successful innovations can be published in peer-reviewed journals

• Quality & Productivity Case Studies - innovations that comprise processes, pathways and systems that impact upon efficiency, productivity of services can be submitted to the Quality & Proclivity series (operated by NICE) for assessment. If the innovation meets specific criteria they will be validated and published.

• NICE - if the innovation involves repurposing diagnostic tests or implementing new equipment (i.e. not technologies that are in their infancy of development) NICE operate a number or programmes through which these innovations can be assessed e.g. the Medical Technologies Evaluation Programme (MTEP). If approved, NICE can help with diffusion through their Health Technologies Adoption Programme (HTAP).

• Commercialisation - Some innovations can lead to the development and commercialisation of a product which will allow the technology to be diffused via the market and can provide income for the organisation and for the inventors (if the local IP Policy enables).

• Media Outlets - Innovations that are relevant to Public Health and lifestyle are often reported in the media e.g. cancer diagnostics.

• NHS England Innovation Exchange - This portal is operated by NHS England Innovation, Health and Wealth and can be used to submit innovative ideas or products, allowing other users to comment and ask questions.


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• Internal Diffusion - Successful innovations can also be diffused to other department in the organisation, via the staff engagement programme and an agreed communication strategy.

• Innovation networks - there are a number of local and regional networks which have an innovation theme including Liverpool Health Partners (LHP), the North West Coast Academic Health Sciences Network (NWC AHSN) and the North West Coast Collaboration for Leadership in Applied Health Research and Care (NWC CLAHRC). One of the aims of these networks is to support the diffusion of successful innovations, and there should be an active programme of engagement with these networks.

The Innovation Support Team should monitor and support innovation projects throughout the Innovation Pathway and therefore will be able to discuss and advise Innovators on the most appropriate means of diffusion of a successful innovation. A number of programmes listed require financial modelling to be undertaken and therefore assistance may be required from departments like the Finance Department to enable the diffusion of an innovation.


Documents

Innovation Management Tasks Innovation Toolkit · PDF fileInnovation Management A guide to using the Innovation Toolkit • Working with your strengths • Supporting your new company