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90INNOVATION UKINNOVATION Innovation - a fantastic opportunity to transform health services The NHS Institute for Innovation and Improvement is a centre of excellence supporting the NHS to transform healthcare for patients and the public by developing and spreading new ways of working, new technology and world- class leadership. It provides a coordinated focus on the biggest challenges faced by the health service and acts as an active " test bed" providing practical new approaches to care delivery. The NHS has a great opportunity within its 1.3 million workforce, all of whom can be innovative, if only they knew it. The NHS is also facing unprecedented challenges to find ways to increase quality without raising costs. Its chief executive, David Nicholson, believes the answer lies in innovation. How can the NHS harness its workforce to be more innovative with a specific focus on increasing quality and productivity? Dozens of Scottish companies have benefited from the innovation centre's ground- breaking advisory support services, which are based in a top- class facility near Glasgow Airport. What do I do on Monday morning? Innovation is a word that gets used a lot, but what does it really mean to a member of its front- line staff? We often get asked, " if I want to be innovative what do I have to do on Monday morning when I come to work?" This, added to the perception that innovation comes from a few clever people who sit in an isolated room and come up with all of the ideas, is the sort of thing we need to tackle in order to maximise the NHS potential to provide high- quality care for all. When we look at innovative organisations across the world we can see that the way they innovate is not random but is a result of a highly organised and deliberate process which all can follow. The NHS Institute has adopted this principle and established its own innovation pipeline through which all new ideas and programmes for innovation progress. This is not a practice that is established throughout the NHS, and the results of a recent survey we conducted with the NHS highlighted the need for its staff to know what to do on Monday morning. Mesages from the front line of care Critical to helping NHS staff with their biggest challenges is to actually understand what those challenges are from the perception of those on the front line of care delivery - the nurses, doctors, physiotherapists and managers. The NHS Institute has just conducted the first national Innovation and Improvement Survey aimed at gathering insights into the techniques and methods currently being used within the NHS to improve health and healthcare services, understanding the challenges being faced on an everyday basis and gaining new knowledge about the support that those involved in making improvements require. Over 4,300 NHS staff responded, telling us that increased training and development in the tools and methods of innovation and improvement was the most important thing they needed in order that they can really transform our health services. Innovation Practitioners coming son The NHS Institute has established an intensive training programme for Innovation Practitioners. The participants have been drawn from across the NHS providers and commissioners, from clinical, operational and improvement leadership roles, all with an ambition to transform healthcare services. They have been coached to use a systematic and deliberate process for innovation, including ideas generation, prioritising and selecting ideas, prototyping and creative implementation. A core component of the training is the use of " open innovation", which means an approach to innovation not constrained by internal thinking, but that stimulates new thinking and new relationships with people from outside health industries. LEFT: Dr Lynne Maher Healthcare NHS Institute for Innovation and Improvement

UKINNOVATION UK91 Innovation practice methods are only useful if they help to deliver better results for patients and populations. Therefore, each of the participants is undertaking a significant project to apply innovation practice in their own setting. Through the projects, the Innovation Practitioners are " thinking differently" about pre- hospital emergency care, orthopaedic services reviews, paediatric high-dependency care and patient discharge communication. They will be coached by our innovation practice experts as they implement their projects over the next six months. The Innovation Practitioners who pass the exams, and are able to demonstrate use of the range of innovation methods and tangible outcomes in quality and cost, will be accredited by the NHS Institute as NHS Innovation Practitioners. Look out for these people because they are joining the vanguard for innovation which will transform health services. New relationships equal new thinking Tom Kelley from the design firm IDEO makes the point that, " companies that want to succeed at innovation will need new insights, new viewpoints and new roles". The concept of open innovation where new thinking is stimulated through relationships conversations and joint working with others has already been embraced by the NHS Institute. Lean processes traditionally used within manufacturing have been adapted for healthcare resulting in more effective and efficient services which have reduced waste and improved the level of real time spent with patients. With the help of experts from manufacturing recruited in to our team these processes have been adapted and translated for health services resulting in a range of highly successful and valued programmes such as The Productive Ward, Releasing Time to Care, the Productive Leader and Productive Community Services. These programmes have already produced many improvements across the NHS including a massive shift of time ( up to 10%) that nurses can spend providing direct care to patients. This time was previously wasted doing unnecessary and unorganised tasks. A direct result of this is a reduction in time that patients need to spend in hospital, thus releasing valuable and expensive bed days. Using the same principles leaders have released time, saving at least one hour per week by managing emails better, 12 hours per week through better organisation of meetings and around two hours per week in managing their overall workload better. Just think of the opportunity that provides for increased focus on quality across the NHS. Similarly, our relationship with service designers has exposed the NHS to powerful tools and techniques which, although commonly used within service design, were new within the health service. One of these is the power of observation, not in the style that clinicians are expert in - where their skills are honed to link symptoms with diagnosis - but observation based on anthropological principles. This has helped teams to understand more clearly what is really happening in the front line of care resulting in new design solutions providing exceptional health service experiences. In recent open innovation challenges NHS portering staff worked with staff from major retailers, banks and distribution experts finding new ideas that they were able to put into practice to provide higher- quality, lower- cost services for their hospital. General practitioners learned important lessons for improving patient access to primary care by working with online concierge services, a water company and experts in customer care and services design. The NHS Institute is a centre of excellence supporting the NHS with its most difficult challenges. It uses a deliberate innovation process to identify and support the widespread dissemination and adoption of innovation, leading to massive improvements to quality and productivity. Perhaps more importantly, it also provides NHS staff with the confidence and competence to understand and use innovation methods to transform services for millions of patients. Dr. Lynne Maher Head of Innovation Practice NHS Institute for innovation and Improvement For more information on the NHS Institute go to: website www. institute. nhs. uk Healthcare NHS Institute for Innovation and Improvement