Scottish Health Innovations Ltd (SHIL) works in partnership with NHS Scotland to identify, protect, develop and commercialise new innovations from healthcare professionals. Registered Number: SC 236303. Registered address: The Golden Jubliee National Hospital, Fourth Floor East, Agmemmon St, Clydebank, G81 4DY
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Innovation is the key to delivering a new model of healthcare that meets the challenges and expectations of modern society
Whilst Scotland has a proven track record of medical innovation, doing the same things we have always done, in the same ways we have always done them, is no longer an option. Our services must evolve to meet new patterns of care, increased demand and technological advances. Innovation is at the heart of rising to this challenge, creating a service that is modern, sustainable, adaptable and at the forefront of medical advances.
Solutions come from within and outwith – from industry and from health professionals. An innovative NHS open to new technology and innovation is a shared endeavour. To support internal innovation, SHIL plays a crucial role, encouraging ideas and innovations from health professionals across the country, then working in collaboration to assess, protect and develop these into viable products and services to transform patient care, improve quality and productivity, and drive efficiency.
With over 160,000 staff working across NHS Scotland it is a rich resource of ideas and innovations to improve patient care; but what is the reality of embedding innovation within an organisation as vast, complex and busy as NHS?
Read More: A Culture of Innovation - how SHIL works to harness the talents of NHS Scotland staff to drive innovation
As part of our #nhsscot70 Innovation Series, we talk to Jill Young, Chief Executive of the Golden Jubilee Foundation. Jill was appointed Chief Executive in 2004 and through a lifetime career in the NHS brings a wealth of experience and skills to the SHIL board including Quality and Innovation, Professional Nursing, General Management, Performance and Strategy. Jill’s commitment to improving quality and safety through innovation and service redesign matched with an unwavering drive to deliver excellent patient care has led to numerous awards including Leader of the Year at the 2016 Scottish Health Awards.
What is the reality of innovation within NHS Scotland?
Innovation is high on the agenda – its importance highlighted in every key strategy and a recent inquiry into technology and innovation in health and social care (Health and Sport Committee) generated significant interest from stakeholders across Scotland.
"There is no doubt healthcare providers, public services, the third sector, patients and the public, and industry are united in driving forward a more efficient, responsive and patient-centred health and social care service."
However, it is naïve to assume evolution of our health service just happens with no barriers, no resistance or hesitation. Realising the potential from new technology and innovation, managing the inevitable changes that need to be made as a result and continuing to provide high quality 24/7 health service is a challenge; however, there is no doubting the significant progress within Scotland to drive forward innovation."
How do we create a culture across health and social care service that values and promotes innovation?
“Nobody has a monopoly on good ideas and creating a strong culture of innovation means that we value innovation from both within and outside the NHS."
This requires strong leadership, encouragement and support to implement new ways of working – whether that be an industry solution into the NHS; or equally so an idea from within the NHS that has potential to transform patient care in Scotland or beyond.
"Within the Golden Jubilee Foundation, a ‘can-do’ attitude is one of our key values and we have established a reputation as a flagship hospital open to new technology and innovation."
This creates a very positive culture; however, to properly support innovation, the right people with the right skills and experience needs to be available. From a staff perspective, this is where SHIL play a crucial role - the services they offer across IP, product and prototype development, raising finance and commercialisation are skills not readily available within health boards – but through SHIL we have access at a national level and their support in guiding staff through the process is invaluable.
"Being able to showcase real products and spinouts originating from health professionals within NHS Scotland also helps establish a precedent for innovation success - people take confidence in things being real and this really helps demonstrate ideas being turned into viable products and services."
Within the Golden Jubilee, we have also created a bespoke Innovation Centre with Inspiration break-out areas; dedicated safe spaces to spark and ignite creative thinking by everyone in the Golden Jubilee team.
From the perspective of implementing industry solutions into the NHS, it’s about being receptive to new ideas and establishing a progressive working culture that is not afraid of change. We have many examples within the Golden Jubilee including our state of the art Motion Analysis Lab (MAL), leading international research and our telehealth outpatient clinics which enables patients to attend their local hospital for a high tech consultation by secure video links. All of these projects require collaboration both within the NHS and with industry partners and importantly patients. The introduction of KEWS300 - a paperless, digital recording system which monitors vital signs - is another exemplar that really shows the successful integration of technology into a busy ward. The system developed in collaboration with Syncrophi Systems allows medical staff to take paperless, digital, recordings of vital signs and observations at the patient’s bedside, then instantly transfers data to a central ward monitor allowing integration of key clinical indicators and easy viewing by the clinical team at any time.
"This system has improved safety and completely eliminated the need for paper charts and observation sheets in our wards and as the technology was developed in collaboration with the team here at Golden Jubilee Foundation it was seamlessly integrated with existing clinical systems so our entire team stopped paper recording within just three days of its introduction – that type of transition between existing and new systems is what’s needed when working in a system as busy as the NHS"
This was an excellent example of the value of technology and innovation when implemented in the correct way. So creating a culture that values and promotes innovation is about remembering that safety and outcomes for people are essential and the new solution is a key part. So involve the front line staff at each stage to ensure the design helps not hinders; and when staff are able to see first-hand the benefits in clinical outcomes, accuracy, communication and efficiency it is extremely motivating, in turn, generating that cycle of innovation.”
What are the biggest challenges when integrating new technology and innovation in healthcare settings?
"Healthcare is a 24/7 service – it cannot stop to allow the development or implementation of new technology or ways of working"
The processes need to run in parallel, that’s what makes innovation so complex in large organisations such as NHS. Testing, implementation and in-depth training of extremely busy staff need to be factored into any new systems, equipment or services being integrated. This is in addition to all the other pre-implementation factors such as quality, safety, financial viability, governance,
"Finding time to innovate amongst clinical or personal commitment is a challenge so we need to simplify this process and provide the right support for staff who do have strong ideas."
That is again where the support of SHIL is invaluable – providing access to resources such as their selection criteria to help refine ideas and then taking care of the day-to-day management of driving forward projects. This sort of collective effort across the whole system is needed to deliver the required step-changes to drive innovation forward. Long-term gains from the integration of innovative solutions are clear but they don’t happen overnight and the transitional phase is crucial to get right.”
Is innovation everyone’s job?
Innovation is ultimately about people and often it’s those working at the heart of our health service that are best placed to devise new creative ways of working. Across health and social care in Scotland we have a talent pool in excess of 160,000 staff, if we can harness all of these talents – front-line clinicians, researchers, nurses, pharmacists, specialists, managers, and support staff across every area – then we should be able to be innovative across all areas and look for new and better ways of operating our service.
The ‘can do’ approach at Golden Jubilee enables us to be a catalyst for change and trial new approaches thus paving the way for others across health and social care to follow.
"Our success can be attributed to committed, forward-thinking, entrepreneurial staff who work in partnership with an imaginative management team."
We understand healthcare innovation is a vast area and needs everyone on board - it can span single devices that transform care of individual patients, to state of the art scanner, robotics and large-scale projects such as the Golden Jubilee’s Caledonian Technique, our enhanced recovery programme which increases quality of clinical outcomes and dramatically reduces length of stay in hospital. It was developed by the innovative Golden Jubilee Team after seeing a similar technique in Denmark demonstrated positive results. This shows there is much to learn from other people, other sectors and other countries; therefore innovation very much needs to be part of everyone’s job. The important caveat is not to confuse innovation with technology – really it’s just about looking for improvements to health challenges and the Rhinopinch from SHIL is perhaps the simplest illustration. A nasal clip to staunch nosebleeds may not first appear to be a cutting-edge innovation but it has been transformational in freeing up staff time in busy A&E departments - in that sense, it is hugely innovative. Furthermore, we must never forget the role of patients whilst delivering innovations that change the way treatment and care is practised and delivered. They too have a role in embracing a range of technologies; allowing them to take charge and manage their own healthcare – we see this in the use of supported self-management tools, particularly for long-term conditions. Other examples are our Electronic Patient Portal, which has been a real game-changer for our work at Golden Jubilee Foundation. As we treat and care for patients across Scotland, the electronic capture of clinical data helps facilitate a more efficient and safer medicines reconciliation and electronic discharge process for the services and patients. It drives efficiency and transparency and ultimately a better experience for both clinician and patient."
What national innovation support is available?
A range of support is available locally and nationally to drive innovation. Golden Jubilee has now established Scotland’s Innovation Fund; designed to develop original and pioneering treatments for Scotland’s patients.
"The fund recognises that for every idea with genuine potential there comes a point where additional resources are needed and so the fund sits apart from mainstream services or research activities that are already delivered through other routes."
Other routes of funding are available via Scottish Enterprise, Innovate UK plus European level funding, and ideas going through the SHIL process will get dedicated support to apply for such funds or look to Business Angel Investment. To ensure an open and receptive environment for innovation there is a great need to work together with funding partners to develop and validate technologies and innovations is crucial. SHIL is already regarded as an important interface between innovative health tech ideas and sources of finance. Adding further strength to this environment of collaboration, the Medical Device Alpha Test (MD@T) is a unique process to review and test medical devices that can be used within NHS Scotland and the wider healthcare environment. It has been developed by clinical experts at the Golden Jubilee Foundation and helps connect business, inventors, funders and clinicians providing a thorough and rigorous testing process that could allow earlier device implementation nationally. This sort of national approach is crucial in streamlining the innovation environment. In addition to funding, general support is also available directly through SHIL and within individual health boards - either via innovation champions or research and development teams.
The Quality Framework for Health is another unique innovation emerging from our dedicated team at the Golden Jubilee Foundation. This unique quality assurance framework is built on algorithms and importantly integration of three programmes: Governance, Quality Indicators and Values-Based Workforce. The Quality Framework digital application provides near ‘real-time’ trends allowing staff to view and analyse ‘up-to-date’ key indicators in quality, safety, performance and patient experience. This could be sickness, skill mix, occupancy and complexity of patients plus hand hygiene and infection rates. It automatically highlights areas of focus such as quality of care and patient outcomes plus; the information can be seen by both staff and patients. Accessed remotely via mobile technology, it offers the potential to view safety and care levels of individual wards whole hospitals or Board, or throughout NHSScotland. The Quality Framework helps to better understand and react appropriately to ensure patients have a safer, high-quality experience.
Using a ‘Once for Scotland’ approach to innovation, this unique concept can be tailored for use in all healthcare settings. It is agile, flexible and is also transferable and provides quality assurance to other public service bodies; by displaying culture and governance structures. Additionally, The Quality Framework has delivered circa 60% of Golden Jubilee’s efficiency savings.
Through the innovative ways I help lead the Golden Jubilee Foundation forward plus my role on the board of SHIL, I am confident the building blocks for innovation are secure because we are creating the right environment across Scotland to support, enable and deliver innovations to healthcare in Scotland and beyond.
"We continue to have an incredible passion, commitment and appetite to drive innovation further and to do much more – this is indeed an extremely exciting time for patients, staff and strategic partners to help us mould the future of NHS Scotland."
Thank you to Jill Young and Angela Harkness at Golden Jubilee Foundation for their contribution. If you would like to contribute to our #nhsscot70 Innovation Series please get in touch via email@example.com