What were we trying to do?

Through its ‘Adopting Innovation’ programme, The Health Foundation funded four ‘Innovation hubs’, led by NHS provider organisations in England. Manchester University NHS Foundation Trust (MFT) hosts one of these Hubs. The aim of the MFT Hub is to drive the identification, prioritisation, progression and evaluation of local adaptation/adoption of innovations. Initially, digital innovations were used as an exemplar. The overall aim of the Hub is to improve health outcomes for the populations which MFT serves.

 

As part of the Hub collaboration, we did a mixed methods evaluation to understand how innovations in healthcare are developed and spread. The evaluation:

 

• found out the priorities of the Hub, its key aims and how these addressed the needs of the local population
• explored how context had affected the uptake and spread of the innovations
• found out what made implementation easier (enablers) or more difficult (barriers)
• explored how the Hub partners worked together and with other stakeholders across the local health and care system, to support the implementation of innovations
• explored the mechanisms through which the Hub influenced the scale-up of research-based innovations across a region, such as existing networks and Hub processes
• described how learning, skill and capacity building for innovation have been provided via the Hubs
• described innovation activity over time, through analysis of combined data
• described and compared the implementation of innovations via the MFT Hub
• measured local impact.

 

 

Why was this important?

International evidence consistently demonstrates slow, incomplete and inconsistent translation of research into practice and eventual patient and population benefit, representing a significant opportunity cost. Funders are increasingly concerned about this problem.

 

A promising solution was the development of collaborative networks bringing together academics, policymakers and health professionals, to foster partnership working between producers and end-users of research, improving the uptake of research knowledge in clinical practice. Previously conducted research studies showed that partnership working improves the translation of research into practical innovation, but significant research gaps remain in relation to the operation of these networks, and the benefits as they mature. In particular, we didn't know how innovation implemented in so-called 'pilot' sites could be spread more widely.

 

The Innovation Hubs act as centres of expertise and support within provider organisations to help them, and their local health systems, become better adopters of innovation. In doing this, health care organisations create long-lasting impact for patients and staff.

 

Understanding how such Hubs function and the extent to which they could deliver what they are set up to do was essential to determining the benefits of the Hub approach.

 

 

How did we do it?

The study was a mixed methods evaluation with an embedded case study design. The study had four components:

 

1. Documentary review

A review of documents and other material related to the implementation of the innovations at MFT.

 

2. Quantitative analysis of activity data

Descriptive analysis of any quantitative aggregated activity data routinely collected by the hub to monitor and evaluate their projects, such as the percentage of eligible sites.

 

3. Qualitative interview study

We interviewed people who had a role in managing, supporting or delivering the innovations. Interviewees were based at MFT and partner organisations. The sampling strategy was purposive and we aimed to interview people working directly to support or deliver each innovation and others with roles at MFT, partner organisations or otherwise related to the hub activity. A thematic analysis of the interviews was conducted.

 

4. Stakeholder survey

The stakeholder survey was undertaken at two time points 12 months apart. The survey was administered to NHS staff (both clinical and managerial) involved in the actual rollout of the selected innovations in their organisations. The survey comprised two main components, namely the Implementation Climate Scale (ICS) and the NoMAD questionnaire.

 

 

Who did we work with?

• Manchester University NHS Foundation Trust
• VOCAL

 

 

Findings

Findings from the evaluation of the 4 Innovation Hubs (in Bradford & Craven, Cambridgeshire & Peterborough, Dorset, and Greater Manchester) showed that:

 

• The hubs had managed to establish themselves within local healthcare settings. Each healthcare setting had an existing process in place to advance an innovation to the implementation stage, so there was already some support for innovations to be adopted and to spread.
• Although each hub started from a different place, each came closer to integrating more closely with local systems and added value, via 1. providing central coordination of innovation activities, 2. sharing information and raising awareness of innovations, and 3. generating partnerships by connecting up important people/organisations involved in innovations. 
• All 4 hubs tended to select from similar activities, for example developing tools for innovators, providing bespoke innovator support, developing educational resources, networking and partnership building, encouraging patient and public involvement, and signposting to innovation resources. 
• Some key enablers were identified that have practical value for NHS staff who want to build or strengthen local innovation processes to improve the adoption of innovations. 

 

You can download the full RAND report via the link on this webpage: Strengthening local innovation-implementation ecosystems. 

 

 

More information

 

 

 

Programme Manager
Gill Rizzello
gill.rizzello@manchester.ac.uk