Are We Innovators?
by Craig Brown

I was speaking to a colleague recently who reflected that it appears we have been through the age of research, then came the age of standards and now we appear to be moving into “the age of innovation” in the NHS.

It was an interesting comment and perhaps picks up the zeitgeist where we have seen the development of “Quality Improvement” initiatives, sometimes on a local scale and sometimes on a regional or national level. The growth and expansion of Academic Health Science Networks (AHSNs) supports this regional transformation through platforms for education, supporting system wide projects and attempting to link innovators with the appropriate clinicians.

However, there is still a problem. Despite system wide changes the adoption and spread of innovation is still met with a variety of responses: “it wouldn’t work here”, “I don’t have time to do this” or “we can’t afford it”. Six years ago Innovation, Health and Wealth identified challenges of “poor access to metrics and evidence on innovators” as well as “financial disincentives”.

Innovation Health and Wealth: Accelerating Adoption and Diffusion in the NHS (pdf)

So has anything changed?

Well, as is often the case in the NHS, the answer is “partially” and “slowly”. A more recent publication, Improved Circulation: Unleashing innovation across the NHS (Quilter-Pinner and Muir 2015) suggests another reason for slow adoption; “intertemporal disincentives” i.e. the “up-front” cost of the innovation is prohibitive despite the potential long term savings.

If only there was a pot of cash for clinicians and commissioners to trial these innovative products…

So how many of you have heard of the NHS England Innovation and Technology Tariff (ITT)?

No, me neither; until a few weeks ago. Announced last year ITT seems to have slipped below the Critical Care radar. From my understanding this is NHS England offering to pay for the products! Yes, they pay for them! Not indefinitely and when the funds have gone then they’ve gone, but still, it’s a start.

Considering one of the products is an endotracheal tube designed to reduce the incidence of VAP and another aims to decrease contamination of arterial lines, I’m curious to know how many clinicians have heard of this opportunity? More information on the products can be found on NHS England’s website at

We can debate how these products were chosen (there is evidence that NICE was involved), the evidence base behind the products, even the cost of them matched against current pricing. And we should have these discussions.

However, is the tariff an opportunity? Given the challenges in securing research funding, or implementing system wide patient safety initiatives are we at risk of missing a trick?

NHS England is due to provide more information about the tariff and the AHSN’s have agreed to ‘support and drive rapid and consistent adoption,’ and provide local advice. There were a number of information webinars in late March 2017, and further information is available from local AHSNs or Imperial College Health Partners.

Now, to be clear, I am not employed by any of these companies, I have no declarations of interest to make, neither is the ICS endorsing any product. They haven’t approached us and they may not even know that this blog exists.

As far as the ICS goes, our job is to let you know it’s out there, but be quick, it may disappear quickly too.