From my experience and learnings at the EMAHSN, I have learnt that there is no single approach to getting healthcare innovations spread in the NHS. It all depends on the complexity of the intervention, the system, culture, and circumstances of the environment in which it is to be implemented.

In my previous role where I was improving patient flow across the emergency and urgent care system, everyone knew that they needed to work differently yet the need to respond to daily demands, coupled with limited funding resources stopped people in their tracks.

Knowing that we just can’t allow ourselves to keep doing the same old same old I joined the EMAHSN in its commitment to supporting the implementation of innovation. It made me hopeful that by bringing together patients, the NHS, academics and industry to scale up the delivery of new ways of working that we could deliver better outcomes for patients.

A real-life example of where this has worked well…  

We have many good news stories in the EMAHSN and The AHSN Network (visit our portfolio of projects to find out more) but there is one in particular that I want to shout about.

The Focus ADHD programme is about supporting services to improve the assessment process for Attention Deficit Hyperactivity Disorder (ADHD) for children using a computer-based test (QbTest) which measures the core symptoms of ADHD, attention, motor activity and impulsivity.

Having been exposed to the research generated by our trusted research partners in the ARC East Midlands we knew that the test had great potential. Their findings suggested that by incorporating QbTest into routine diagnostic assessments, clinicians were 44% faster in reaching a diagnostic decision and clinicians were 77% more confident in their diagnosis.  Like handing over a baton, we quickly established a demonstrator programme to put these findings into practice in the East Midlands in three trusts, supported by a real world evaluation to find out if our results could mirror their findings. The evaluation didn’t disappoint. Over the 12 month demonstrator programme, we proved that the use of the objective computer test alongside other clinical information can provide a more rapid diagnosis (or rule out) with a reduction of around five months after fewer patient visits (at least one), whilst improving patient, family and clinician experience. 

With all the great evidence findings, where did we go next?

Excited and ambitious, the 15 Academic Health Science Networks across England (the AHSN Network) came together for a common cause - aiming to scale up the number of trusts who would offer this objective assessment as part of their assessment process.  We wanted as many children as possible to benefit from a quicker assessment process so that they could be supported with whatever is needed to help them be more effective in their day to day life.

The argument for need was quite simple. Most families with children who potentially have ADHD, have to wait a ridiculously long period of time to get into the system and get a diagnostic decision. Data suggests that many can wait for over two years to be seen in a hospital setting and additional 18 months to be given a diagnostic decision.  This can vary significantly depending upon where you live in the country.

Armed with the need for the intervention alongside the evidence base we took great strides in upskilling the AHSN workforce to host the necessary conversations in their systems – bringing together clinicians, managers, patients, commissioners, the product supplier,  educational leads, the charity sector to ask the key questions – two of which I believe to be core - “what's broken in your system” and thinking specifically about the implementation of the innovation - “why not”? We weren’t naïve, no matter how easy any innovation is to implement and how persuasive the evidence is, the scaling up can be challenging.

But after nearly two years of being a national AHSN network programme, we can now proudly declare that over 59 trusts across England, across more than 111 sites have the QbTest embedded in their pathway.  More than 58,000 children have now had an objective assessment since we started our East Midlands demonstrator back in 2017.

I feel so proud to share this good news on behalf of everyone who has enabled this to happen. It has and continues to be collaborative and compassionate leadership that is delivering this programme across multiple sectors.  Actively listening and responding to the children and their families as well as the services who are chasing their tails has been critical to the success.

Collectively we are embedding technology to reduce the time for assessment, release clinical capacity by removing unnecessary appointments, increase clinical confidence in decision making and most importantly make the experience of families and children better. 

What resources are available?

The adoption and spread of innovation is not always straightforward but with a bit of planning, networking and resilience it can lead to impressive results. There is no manual as to how to support the adoption and spread of healthcare innovation in the NHS but I have developed a quick guide on areas to consider to give you the best chance of success. View the guide here.

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