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  • Ann Porter

Is the NHS actually the most innovative organisation in the world?




Innovation is not a new concept. It is all around us, everywhere, from technology to services to products to new business models to public policy. It is a subject for research across academic disciplines, has become a topic for discourse across industries, professions and government organisations and has spawned a whole innovation industry. In public service, some commentators have even referred to innovation policy as ‘policy chic’. It is a hot topic. Innovation is seen as a key ingredient that determines the survival or death of economies and organisations today.


But how ‘to do’ innovation is fraught with conflicting theories, fads and fashions. Innovation knowledge has grown at a fast and furious pace over the last 20 years. Theories about how to innovate in the NHS are emerging but are not yet terribly coherent. Innovation methods are currently drawn from different intellectual traditions and a values spectrum that has innovation as a mechanistic, de-contextualised, applied science at one end and innovation as a grass-roots, entrepreneurial phenomenon at the other end.


Whatever stance innovators take, two core assumptions prevail. The first assumption is that the NHS is not terribly good at innovation and could do better. The second assumption is that bureaucracy and bureaucrats stifle innovation.


What if the prevailing received wisdoms are not true? What if we reverse our thinking and start from the point of view that the NHS is actually the most innovative organisation in the world? What kind of theory of innovation for the NHS might we come up with then?


An entrepreneurial social movement

The greatest healthcare innovation from the last century-the NHS itself- was born out of a social movement. All the values, passions and drivers that led to its inception are still there across the system. If we capture, connect and mobilise the latent entrepreneurial talent that already exists in every single NHS organisation-staff and patients –we will build a sustainable innovation momentum.


For several years, Fuel for Innovation has been running a pioneering programme, ‘Entrepreneurial Competencies for Doctors’, for third year medical students at Brighton and Susses Medical School. This programme, assessed as part of the medical degree, equips students with the knowledge and competencies necessary to steer ideas for innovation through a complex, administrative system. The course is tough because students, at the start of their careers, have to learn how the NHS works; come to grips with the business disciplines for innovation (which are different to those for day to day management) and to learn how to navigate through four layers of organisational ‘logics’. As future clinical leaders and innovators, they have to learn to be ‘ambidextrous’.

In driving forward innovation in the NHS, medical students are a major, unexploited resource.


Ideas for innovation produced by medical students

  • Improvement of clinical outcomes and patient experience by creating a quieter ward environment through the use of protective earmuffs. The idea was developed through brainstorming how noise is reduced in other environments.

  • A product to help prevent needle stick injuries.

  • A new, integrated community based service model to tackle the complex causes of obesity rather than dealing solely with the symptoms through medication and bariatric surgery.

  • A technology platform ‘Elective Swap Site’, to improve the efficiency and outcomes of elective placement allocation for all medical students across the UK.

  • A combined ‘incentive and reminder’ scheme to reduce the number of DNAs that could produce significant savings for the NHS. Students designed an integrated delivery model that made connections across a number of ideas from different disciplines.

  • A product (a custom made bag that could be easily sterilised and mass produced) to enable doctors to carry essential equipment from patient to patient.

  • A social marketing campaign to tackle MRSA based on an observation by one student that many doctors on the ward did not clean their stethoscopes between patients.

  • Fresh thinking about electronic patient records and how to manage this locally and cost effectively.


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