In this blog, Health Innovation East Midlands Managing Director Nicole McGlennon reflects on the ongoing outstanding impacts of a former national programme to accelerate the diagnosis of ADHD – and identifies some of the key learnings relevant to any NHS transformation project. 

*** 

Our national Focus ADHD programme was launched across England’s 15 local health innovation networks (HINs) in April 2020, right at the start of the Covid-19 pandemic – a challenge considering the programme is based on digital technology (the QbTest developed by innovator Qbtech) delivered in-person by a clinician to patient. 

Despite the obvious challenges the pandemic presented to delivering face-to-face services, implementation rapidly accelerated across all NHS regions and by March 2024 the QbTest was being used in 75% of all NHS trusts that provide ADHD services. 

During that four-year period over 70,000 children and young people benefited from the innovation, releasing more than 95,000 hours of clinical time, and saving the NHS an estimated £38.5M. 

Aside from these outstanding impacts, what’s notable is that this national HIN programme completed in March 2023 – but the impacts continue to be sustained, evidence that it has become ‘business as usual’ within the implementing trusts; indeed, the impacts have continued to accelerate following the end of our formal involvement, with a further 10 trusts adopting QbTest during 2024 benefiting 15,800 more children and young people. 

So, what were the critical success factors that enabled the 15 HINs to rapidly scale this programme from a local East Midlands pilot to complete coverage of England – and become business as usual within 79 NHS trusts – within just a couple of years?  

We all know the challenges facing our NHS and wider care system and the pandemic focused us on the potential for transformative technologies, systems, and ways of working to reimagine services and pathways. 

But for NHS organisations, driving change alongside tackling day to day challenges is not easy; we may have the will but it’s hard to create the capacity to make transformative change a reality.  

The 15 health innovation networks (HINs) have a prime role in helping make this change happen – we are experts at enabling transformation, and work across and connect all health and care sectors.  

Since we were established in 2013 the HINs have created a national NHS pipeline that currently features more than 2,000 evidenced innovations that respond to local priorities – both cross-cutting themes such as tackling health inequalities and cutting waiting lists, and clinical challenges such as cardiovascular disease and mental health.  

Focus ADHD is one example of rapid implementation of an innovation programme across a wide geography (in this case, England) involving dozens of partners across the NHS, wider healthcare, commercial, research and third sectors – underpinned by patient involvement.  

The programme was based on adopting the digital technology QbTest, which measures all three components of ADHD (attention, impulsivity, and activity). Used alongside clinical assessment the tool reduces the time to diagnosis and frees up time to enable clinicians to focus on more complex cases (for more about the benefits of the QbTest, see this NICE Medical Innovation Briefing).   

The programme’s success factors are captured in a ‘blueprint’ document, “Innovation implementation, readiness and resourcing” that collates learning from across the 15 HINs.  

This insight – is relevant to anyone seeking to develop and successfully implement an innovation or transformation programme within health and care settings – and focuses on five key areas:  

1. Understand the context: 

• Establish the clinical and operational drivers for change and understand the evidence base.  

• Consider how the project aligns with regional and national guidance, strategy, and policy.  

2. Raise awareness: 

• Identify the organisations and individuals who will implement the programme.  

• Develop consistent messaging and communications toolkits.  

3. Build will: 

• Identify the key stakeholders critical to success – not just those who will implement the programme, but also champions who can be vocal advocates for change.  

• Listen to people’s experience of care and capture patients’ voices.  

4. Support implementation: 

• Ensure operational and clinical staff are in place to implement – and sustain – the change.  

• Keep track of progress and build ongoing input from partners.  

5. Change behaviour: 

• Celebrate success – for example regular updates on the positive impacts to reinforce the benefits of seeing the programme through and ensuring it is sustained.  

• Provide ongoing support, for example through implementation resources and communities of practice to share experiences and positive case studies.  

I hope you find the guide and the supporting resources useful, and you may also find helpful this recording of this webinar about learning from the Focus ADHD programme.   

Support from the Health Innovation Networks  

Established in 2013 (formerly the AHSNs) the health innovation networks are innovation adoption experts – they seek to transform lives by supporting health and care teams to find, test and implement new solutions to the NHS’s greatest challenges. 

They operate locally and come together to address health and care priorities by speeding up the coordinated spread of innovations – from medical technologies, devices and apps to digital systems, medicines, and wider pathway transformation.  

They develop partnerships across all sectors involved in health and care transformation including the NHS, social care, public health, research and voluntary organisations, and the private sector (including medical technology and pharmaceutical companies).  

With more than 10 years of expertise and knowledge, your local HIN can help advise and guide organisations and individuals seeking to implement innovation.  

To find out how we can help you, get in touch with your local health innovation network.