New review of approaches to the spread and adoption of healthcare innovation

An in-depth study examining approaches to spreading and adopting innovation in the health sector has been published today by the Academic Health Science Network (AHSN Network).

The review will help England’s 15 AHSNs that collectively form the AHSN Network and their partners, understand and harness their collective experience and expertise.

The AHSNs were established by NHS England in 2013 to spread innovation at pace and scale to improve health and generate economic growth. Each AHSN works across a distinct geography, serving populations within regional health systems to spread innovation, whilst also operating as a connected national network.

The review, which identifies the different approaches used across the 15 AHSNs within the Network, highlights the complexity of spread work; the diversity of approaches; the influential factors; and provides recommendations for the future.

The research was undertaken by three study partners, the Centre for Healthcare Innovation Research (CHIR) at City, University of London. Wessex AHSN and South West AHSN.

This research provides the first aggregated view of approaches and challenges to spread and adoption across the AHSN Network, to help the AHSNs and its partners understand the complexity and variation. As well as mapping approaches across the AHSN Network, the review included a deep dive into the Transfers of Care Around Medicines (TCAM) national program.

Professor Gary Ford, chair of the AHSN Network and chief executive of Oxford AHSN said:

“This review expands our knowledge base and will increase our capability to spread innovation in the NHS. Since our formation in 2013, the AHSNs have amassed significant expertise in the approaches and challenges to adoption and spread of innovation. The findings of this review highlight the considerations AHSNs take to their individual approach to adoption and spread and provides us with an overview, which will enable us to reflect and learn.”

“The review highlights a number of factors to consider and different types of approaches, which will be of use to those in local and national systems trying to spread innovation.”

Professor Harry Scarbrough, CHIR co-director, and co-author of the review, said:

“CHIR’s work is very much focussed on helping healthcare providers overcome the challenges of putting the latest technologies and treatments into practice. So this project was a great opportunity to work with the AHSNs who are the real champions of this kind of innovation in the NHS. We are delighted with the outcomes from the study as we believe it will really help support the AHSNs in delivering these benefits of innovation to patients right across England.”

Dr. Alexandra Ziemann, CHIR Senior Research Fellow, and review co-author, said:

“It was very interesting talking to AHSN staff members, learning from them what it takes to spread innovations in the real world and how that compares to scientific theory.”

The review was commissioned and funded by the AHSN Network and the NHS England Innovation, Research and Life Sciences (IRLS) team.

All 15 AHSNs participated in the study, which took place from January to November 2020, studying spread and adoption activity between January 2018 and January 2020. 143 interviews were conducted with AHSN staff to identify approaches applied by each AHSN to local/regional and national spread programs.

A synthesis of findings was used to develop conclusions and recommendations about spread and adoption for the AHSN Network.

Major findings from the review were:

A range of high-level and project level approaches to adoption and spread were identified and described in the report.
There was no single methodology or ‘one best way’ to do adoption and spread, reflecting the inherent complexity of adoption and spread work, and diversity of activities within AHSNs.
Flexibility with approaches is paramount due to the dynamic and multifaceted nature of health systems.
Despite some innovations being intrinsically ‘simple’; the contexts, people, and pathways they touch are usually complex, therefore adoption and spread are complex.
AHSNs reported success using whole-system and relationship/engagement-focused approaches, engaging existing networks and building new networks across sectors and organizations.
To spread innovation, it’s important to think ‘system’ and engage widely. This increases ownership within adoption sites from the start and supports sustainability.
The research highlights the depth of spread and adoption experience and expertise across the AHSN Network. The report concludes with 24 recommendations which the AHSNs and wider health system can learn and benefit from, increasing their capability to successfully spread innovation.