Written by Barbara Harpham, Chair of the Medical Technology Group
When the NHS celebrated its 75th anniversary two years ago, a “culture of innovation” was described as vital to the NHS’s longevity. The NHS does indeed have a number of successful initiatives that have allowed technology to support it in recent years. But the requirements of any innovative culture have since become more existential. It must now become a wider transformative force that delivers a new model of care fit for the 21st century.
Is our present culture of innovation up to this challenge? The verdict from clinicians and patients when we consider the shift from analogue to digital, treatment to prevention and hospital to community would suggest not. This is ultimately built on an acute frustration, but one that also provides reason for optimism: there is a wealth of innovative practices and technology being used in the NHS. But often it exists in pockets. We struggle to fully harness the wealth of talent and innovation latent in our health service.
The reasons for this are no secret, but now widely spoken about whenever the “innovation” word crops up. A lack of ring-fenced funding, trouble scaling proven technology, procurement bureaucracy. An unprecedented crisis has left clinicians time poor, siloed and risk averse. We now often hear that those trying to do things differently feel like the system is working against them rather than with them.
How can we overcome these challenges and create a culture of innovation that can transform the NHS? This is the question we hope to answer as the Medical Technology Group embarks on its most ambitious project yet. Over the next two years we will provide insights from our landmark Commission on NHS culture for innovation and technology. This will be built on what we see, hear and encounter across the system – speaking to everyone from senior policy makers to local trusts alongside clinicians, innovators and patients across the system to work out what we do best and how to scale it.
Proposing a “change in culture” risks falling on deaf ears. Change is notoriously difficult to measure, at risk of falling back on mere descriptors or anecdotes without providing practical steps or incentives to change at a granular level. But we believe it can be measured and implemented by studying the intersection of five core components – value, accountability, best practice, patient involvement and collaboration. From these points of inquiry, we will hope to derive evidence-based recommendations that will drive entire system change.
We will start by mapping the medical technology maturity of all 42 Integrated Care Systems in England. This will examine how closely each follows the relevant NICE/Clinical Guidance for five fore clinicals areas: cancer, musculoskeletal health (MSK), continence care, cardiovascular disease and diabetes. From this, we will derive an understanding of best practice in the adoption of approved and appropriate medical technologies that best support clinicians.
Building on this, the MTG will map the varied understanding of value across the system and among different organisations involved in medtech policy making, seeking to understand a definition that looks past financial cost and towards the wider social, economic and environmental value of medical technology. This will support the current work led by David Lawson at the Department of Health & Social Care on value-based procurement.
We will then look at accountability measures regarding the adoption of appropriate medical technologies. ICSs are bound by law to promote innovation in the provision of health services, however two years into this system, vast variation exists in practice. The MTG will seek to better understand these accountability measures that can drive and encourage changes in culture.
We will also continue to build on our meaningful patient involvement work. Patients often provide the best insights into technology and innovation that works, but often their representation can be tokenistic. In 2026, the MTG will publish a renewed guide to meaningful patient involvement, reviewing all the organisations that interact with the delivery of care and assess system change in patient involvement.
Lastly we will look at ongoing difficulties with collaboration among decision makers across the system – from NHS Supply Chain to NICE, the DHSC, and the Department for Science, Innovation, and Technology. It can often be unclear where policy decisions start and end, and who is ultimately responsible for both their creation and implementation – particularly in relation to understanding value for the patient.
It’s time for a Commission on NHS culture for innovation and technology. The insights we gather over the next two years come at a time of exciting and unprecedented change in the health service. We hope to be at the forefront of helping the entire system learn from the best – working with the most ambitious leaders, innovators and patients to build a health care system fit for the 21st century.
