Toby Lambert, Executive Director of Strategy and Population Health, North West London Integrated Care System (ICS), and Clare Thomson, Mission Portfolio Lead and Innovation Lead at Imperial College Health Partners (ICHP), explore how NW London is creating the conditions for innovation success.
Around the world, healthcare systems often struggle to implement innovation systematically and in a timely way. However, the pandemic showed that health systems can innovate rapidly, but only when there is a clear mission and coordinated support to make change happen.
Evidence shows that doing fewer things for longer, and in a more coordinated way can deliver more impact for populations[1]. Embracing the lessons learnt in the pandemic, the NW London Research & Innovation (R&I) Board - consisting of senior representatives from across NW London’s ICS, academic institutions, and R&I bodies - advocated to shift to a new mission-led model.
The NW London missions are a deliberate portfolio of innovation projects focused on a defined number of system priorities that have the potential to benefit from innovation. These priorities (missions), identified by the NW London R&I board, are: optimising care of long-term conditions, starting with cardiovascular disease (CVD); ensuring the right care setting to reduce harm, known as ‘enabling more days at home’; and supporting children and young people’s mental health.
Mobilising the Missions
Since embarking on these missions at the start of this financial year, as an R&I ecosystem we have undertaken a rigorous review of innovation across the sector to identify key opportunities for innovation. This has included extensive research into each mission area; in-depth engagement with system leaders, frontline staff, and patients; analysing quantitative data; and horizon scanning for new innovations or ideas that have proven successful elsewhere.
Coordinated by Imperial College Health Partners (ICHP), who as the innovation partner for NW London have led on mobilising the missions, this review has brought together the views, experience and knowledge of hundreds of stakeholders from across the sector - including primary care and secondary care, charities, local authority, schools, patients and carers, and the pharmaceutical and life sciences industries - in a way that’s never been done before.
The learning acquired from this process has been distilled into three ambitious mission aims, and a shortlist of projects and activities that are showing promise. The next phase is now about trialling and testing these priority projects in our unique NW London context. For this, we need innovation networks.
Innovation networks: establishing the best conditions for change
Innovation is a team sport: it works best when all the necessary players are supported to play specific, but coordinated, roles. A mission-led approach requires relevant players within the ecosystem - including our colleagues in the life sciences industry - to come together as partners and put into practice the methods that we know deliver sustainable change. We are beginning to coordinate this whole team effort through smaller groups of ‘innovation networks,’ whose specific expertise, experiences, or population need will support us to effectively test, adapt and adopt the new approaches we are testing.
Numerous examples of innovation networks already exist in our local system and have a track record of supporting the adoption and scaling of innovation in NW London. The NW London Lipid Management Pilots used an innovation network of trusts, PCNs, the CVD Clinical Risk Group, the CVD exec and industry partner Daiichi-Sankyo, to test a new proactive, integrated approach to tackling cholesterol issues using virtual reviews, that resulted in 86% of the patients involved reducing their cholesterol levels.
The specialist respiratory diagnostic hublets (RDHs) that rolled out Fractional Exhaled Nitric Oxide (FeNO) testing in the community were delivered by a network that included the NW London ICB, respiratory consultants, the Accelerated Access Collaborative (AAC) Health Innovation Network (formerly the AHSN Network) and, crucially, primary care providers across eight boroughs. The partnership resulted in the earlier identification of 461 people with probable Chronic Obstructive Pulmonary Disorder (COPD) and 735 people with probable asthma. Patients are now on the correct treatment pathway which may prevent them needing emergency care in the future.
The missions will capitalise on established relationships and partnerships, as well as build new ones, to test innovations in a series of real-world settings - such as a hospital ward or PCN - referred to as “implementation sites”. Innovations that prove effective in implementation sites will be spread across networks, and then scaled to other networks to create further learning, a broader impact, and to systematise this more coordinated and iterative way of working.
Involving the entire ecosystem in the process means we can adapt, refine and measure the impact of innovations in a series of real-world settings, and share the conditions needed for an innovation to succeed with the whole system.
Prioritising opportunities that are both powerful and possible
The networks we build and implementation sites we select as part of the next phase of mission delivery will vary in type, depending on the mission and the context for delivery. One thing that will be true of them all is that they will be a coordinated and collaborative endeavour, reliant on everyone embodying a mission-led mindset. Each site will have a specific, bespoke team, designed to bring together staff from across the NW London ecosystem with the right capabilities to deliver on the the innovation area, including staff from ICHP.
Our discovery phase has uncovered a multitude of best practice examples in our thriving NW London R&I ecosystem. Through this next phase of networked innovation, we can take this learning and spread innovation further, faster so the whole system can benefit.
Learn more about the NW London missions here.
If you’re interested in becoming a part of emerging innovation networks for the NW London missions, email communications.engagement@imperialcollegehealthpartners.com or get in touch with ICHP’s mission leads:
Mission 1: Optimising care of long-term conditions (starting with CVD)
NHS North West London Senior Responsible Officer: Toby Lambert
ICHP Mission Lead: Clare Thomson
Mission 2: Enabling more days at home
NHS North West London Senior Responsible Officer: Rob Hurd
ICHP Mission Lead: Matthew Chisambi
Mission 3: Supporting children and young people’s mental health
NHS North West London Senior Responsible Officer: Charlotte Benjamin
ICHP Mission Lead: Kenny Ajayi
[1] Mission-Oriented Research & Innovation in the European Union: A problem-solving approach to fuel innovation-led growth (2014) Mariana Mazzucato