BLOG: Spreading innovation in health & care – why context matters

Our Chief Executive Officer, Jon Siddall, shares his reflections on our experience of spreading innovation in health and care in advance of NHS Confed Expo this week.  

This week I will be joining colleagues from the AHSN Network at Confed Expo to share the insight and learning from our work spreading innovation across the health and care system. I’m looking forward to hearing from colleagues from across the AHSN Network and wider Accelerated Access Collaborative (AAC) share their experience from a portfolio of work that in the last year alone has benefited over 480,000 people and created 565 jobs. You can read more about our work as a Network in our AHSN Network Impact Report and impact of our work in the South West in our latest annual review. 

Central to the success of much of this work is the underlying evidence for the innovation and the demonstration of its benefits in a real-world setting. However, as the scale and breadth of our work as a Network grows, one of the things I’ve reflected on is that although evidence is vital for the adoption and spread of innovation, it’s not sufficient. And that’s because the context matters.  

Health and care systems across the country share many of the same overarching challenges – whether that’s responding to the elective care backlog, improving health inequalities or addressing the underlying workforce pressures across the system. However, our experience in the South West suggests that although the challenges are often similar across different systems, the reality about how to tackle the challenges depends on the local context.  

For example, realising the benefits from adopting innovation in a rural and coastal region like ours can often be quite different to those of an urban area – where research and innovation infrastructure and investment may often be focused. Within a large rural and coastal region like the South West, context also matters at a very granular level. Last year’s Chief Medical Officer’s annual ​report on coastal health sheds some light on the significant variation in equity of health within coast and rural regions.  

Adopting and realising the benefits from an innovation in an inner city environment like Plymouth then, can be really quite different to a market town like Bridgwater or a coastal place like Ilfracombe.  

However, context is about more than just the nature of the place or population – it’s also about the context and ‘readiness’ of the system adopting the innovation. And in our experience, it’s often the systems in greatest need for the innovation, that have limited capacity or access to the expertise to adopt innovation successfully. Practical challenges experienced by smaller teams include creating the time to identify and adopt innovation and accessing the expertise to assess the benefits of innovations and capturing learning. Places like the South West often have a smaller, more dispersed underlying innovation support infrastructure. 

Building the capacity and capability of our health and care systems in the South West has, therefore, been at the core of our work as an AHSN for many years – from developing improvement capability across our local systems through to helping teams design projects for scale through our Spread Academies.  

Central to our capability building approach is supporting our partners to develop and use learning system methods – embedding data, evidence and evaluation into the core of programme design and delivery. Our recent work with West of England AHSN on PERIPrem is a great example, using a learning system approach to spread a bundle of 11 evidenced-based perinatal interventions to reduce neonatal mortality and severe brain injury for preterm babies. You can hear more about PERIPrem at ConfedExpo – where our Evaluation Lead Dr Hayley McBain will be sharing more about the impact and learning from programme. 

During the last year we’ve been working with our three new Integrated Care Systems to consider how to use this experience to strengthen the conditions for innovation in our region. We’re drawing on our learning together during the pandemic around the conditions for rapid change and the wider experience from across the AAC and AHSN Network, to help realise the opportunity through transitions in integrated care.  

If you’d like to find out more about our work and why we think context is so important, I’d also recommend joining my session with the AAC and AHSN Network team at Confed Expo – focused on the principles of how to adopt and spread innovation.  

And for those of you that can’t make Confed Expo this year, please do get in touch – we’re especially interested make connections with people who share our interest in transforming lives through innovation in health and care in rural and coastal places like ours.