Innovation in a Healthy Context

Misunderstanding what innovation is and how it works is unhealthy: it leads to chronically weak returns on investment and can lead to economic decline that could prove terminal.

Most people’s talk of “innovation” is non-specific fuzzy feeling talk: not so much discourse as pure marketing. We witness their struggle to say what they mean, but they are determined to convince us that they are on the side of the angels. “We believe in innovation” comes easily to people who declared their mothers to be the best mothers in the world, grew up believing in peace and freedom, joined companies in which “our staff are our greatest asset” and, if they went into healthcare, now “put patients unapologetically at the centre of everything we do”.

(Note by the by: be wary of people who busy themselves with not apologising for things nobody would dream of making them apologise for at all: that too is marketing: “I am one tough dude.”)

Hardier and more thoughtful souls who bear the scars of actually trying to convert innovative thinking into innovative action know that the best that can be said for innovation where there is no execution plan is that this is the sound produced when genius talks to itself.

Understanding what constitutes innovation matters for all kinds of reasons in healthcare, not least because the UK’s Health and Social Care Act 2012 stipulates that Clinical Commissioning Groups have a statutory duty to “promote innovation”. But needing to promote innovation is not like needing to drive within speed limits. We know what those limits are – or can find out – and all but the boy racers among us have a good idea about how to drive within them.

Overcoming the many barriers to fresh and creative thinking, and then working out how best to implement the bright idea: that is where genuine innovation gets measured. All the better if the business model for execution has a scaling mechanism so that the effects spill out beyond the doctor’s lab, the genius inventor’s garage or the too often maligned pilot study. And best of all is the scalable execution plan that is communicated appropriately to all the key stakeholders.

A more execution-focused definition of innovation is vital to the UK’s health sector. On the one hand, academic life sciences and the country’s research centres of excellence lead the world. The UK punches above its weight in natural sciences but has less success in commercialising that inventiveness. But it says a lot about health innovation that the public sector speaks all too passively about its “adoption”. Where are the momentous products of the human imagination that simply adopted their way to success? We need to be much, much bolder than this.

For too long now, accountabilities and incentives have been insufficiently aligned to bring any closer the success that can seem at first to be shimmering tantalizingly on the horizon. The resulting investment myopia focuses instead on incremental process improvements in the shorter term rather than anything truly disruptive. After all, what is truly disruptive is never designed to be merely “adopted”.

Another trait of the “tough dudes” referenced earlier is their bold talk about 24/7 commitment, as if sleep were for wimps. But if we’re going to swagger, let’s widen the scope here. Healthcare is not limited to a 24/7 commitment any more than its sole focus is the point of care and exists just for patients. The reference frame is really 24/7/52/90; it’s everywhere; and it’s for people, not just for patients. And critically, the NHS itself is the box that we need to be thinking out of.