After the failure of the Choose and Book system, innovators need help in cutting through red tape
Innovation was marked by the new NHS England chief executive Simon Stevens as a major priority in his maiden speech in post. He said breaking down barriers to driving innovation from organisations inside and outside the health service would be a make or break issue for the future.
However, with the negative coverage of the replacement of Choose and Book, it is clear internal and external innovators will need all the help Stevens and others can give them to help cut through red tape and ingrained ways of working.
Here are my five top tips on how to establish new, efficient and modern ways of working which de-risk projects, speed up innovation and deliver for patients:
Start small and iterate
De-risk your project by experimenting. Don’t spend months building a solution in isolation and then expect it to just work. Run experiments, mock up products and test them. Build a small subset of functionality and test it with real patients. Measure what they do. Keep what works and throw away the rest. Repeat. The best products start with the genesis of an idea, which is then refined in the real world to be something greater than its originator could ever imagine. This approach is low risk as little time and money is invested early on.
Use data to make decisions
Measuring what users (patients, clinicians, NHS management and admin staff) do can lead to unexpected insight. Develop project metrics early on and use these to make data-driven decisions about what works on both functionality and design.
Design something better that works in context
To some people innovation is something that has never been done before. A new drug fits into that category. Those innovations spread easily. Whether it is a better drug, a faster procedure, or technology, innovation needs to solve a challenge. For most people this means faster, easier or more convenient. The end result of the original Choose and Book didn’t do this as it was cumbersome to use.
Listen to patients, spend time on the ground
Patients are the soul of the NHS. However, they’re often missed when discussing and deploying new technology. Putting the patient first and listening leads to insight. At DrDoctor, our plan to build a smartphone app quickly changed when patients told us SMS and email would be most helpful. We duly built on those technologies first. Anyone serious about innovation in the NHS needs to spend time in clinics, in operating theatres, or anywhere that helps to understand the real challenges faced in the day-to-day running of a hospital. Many inventors have come up with some spectacular tool that solves the wrong problem. The original Choose and Book was an example of this – the system was more difficult than the traditional method of writing a letter, and so GPs understandably didn’t want to use it. Only by spending time with the doctors, nurses and healthcare assistants who make up the frontline teams will the real challenges become clear. Solve those, and your innovation will flourish.
Be tenacious by using robust products and evidence base
The road ahead is treacherous. At each stage your innovation will be challenged. The NHS is, rightly, risk adverse. As an innovator, your job is to anticipate and find solutions to roadblocks – information governance, procurement, evidence. Think about any information governance issues that might arise, map the risks and have robust reasons why your product is safe. Have evidence that shows your product can work, demonstrate how it improves patients’ lives, outcomes, and saves NHS staff time and money. Share that evidence as widely as you can.
Innovation must start on the ground, be proved, and slowly connect the dots, not start at the top and be forced into place. As with any new way of doing things, the bottom line is that users need to feel ownership and see the benefits.