A hunger for innovation must be matched with an appetite for risk

Earlier this month, Sir Keir Starmer outlined his vision for transforming the NHS, stating “we need an NHS hungry for innovation”. As a part of the health innovation network, I welcome the new Government’s focus on transformation, having seen first-hand the huge productivity and patient benefit gains of many innovations associated with the three shifts: analogue to digital, hospital to community and treatment to prevention.  

While technology is often the focus of transformation, implementing new ideas successfully in our health and care system – both pathways and products – will require the NHS to prioritise organisational and cultural shifts, ensuring that behavioural changes and practical support are put in place for long-term adoption.  

Central to this is the need for our health and care system to become more comfortable with the uncertainty associated with innovating; To create an NHS hungry for innovation, we must increase our collective appetite for risk.  

Navigating failure and risk  

Embracing risk is a big part of the culture required to innovate. By clearly defining risk appetite, it signals that some degree of failure is acceptable as part of innovating, which leads to people being more likely to propose bold ideas and learn from setbacks. 

Public sector organisations are often very risk adverse due to public scrutiny and accountability. Our experience of working with academia, NHS and Life Science partners, has demonstrated that successful innovation teams aren’t afraid to take bold steps and learn from their mistakes. This can only happen safely in a learning system approach where constantly testing, refining, and improving ideas based on real-time feedback and data keeps the project dynamic and responsive. Strong leadership support is crucial to creating a culture where innovation can thrive.

Ensuring risks are managed appropriately 

Boards and organisations need to consciously consider their collective appetite for risk aligned to strategic goals with high impact on service delivery and societal benefits and articulate it clearly as part of decision making.  

This will reassure stakeholders that risks are being managed responsibly and garner support for innovative projects even those with perceived high risk. If they don’t, it may hamper the ability to innovate successfully while ensuring accountability. 

Having a defined risk appetite framework will ensure decisions are made with a clear understanding of risks and benefits, reducing ad hoc or overly cautious approaches and enabling experimentation of new ideas, technologies or approaches without the fear of punitive consequences. Through transparency of decision making as part of governance arrangements, trust in innovation initiatives is encouraged with reduced risk of individual bias. 

It also helps in deciding where to allocate resources by balancing potential impact against acceptable risks to achieve strategic objectives.  When making decisions on where to invest, higher tolerance areas such as digital transformation can channel investment into novel technologies.  

Building workforce capable of managing risk 

The best ideas for innovation often come from the frontline, as NHS staff, directly involved in healthcare delivery, are in the best position to identify and solve problems.  

We need to fund the changes, not just the tech, ensuring that investment goes creating environments where creativity flourishes, allowing teams to think outside the box and explore unconventional innovative ideas. By operating with a high degree of autonomy, these teams can take calculated risks and embrace failure as part of the learning process. 

Equipping our workforce with skills in managing risk along with innovation skills is imperative to this. The Innovation Ecosystem Report stated “NHS England, professional bodies and the Royal Colleges should develop capability frameworks for innovation for all staff, clinical leadership and board-level executives and non-executives” as it’s recommended route to delivery. Supporting better partnership working between Industry and the NHS is another way to crowd in the vital innovation skills needed. 

We must also consider how we recognise and reward staff who take calculated risks and drive innovation as champions and support and nurture staff who want to drive change. 

A pro-innovation public 

We should be visibly championing innovation testing and adoption to all, including the public. A specific recommendation of the Innovation Ecosystem Report was for national clinical leadership to identify 200-300 innovation leaders to act as champions for innovation which could be a great driver for change both locally and nationally. This recommendation included working with patient groups to identify citizen innovation leaders.  

Involving patients and the public not just in the development of innovation, but actively seeking to understand their appetite for its implementation in their care, as demonstrated by the deliberation delivered as part of the Secure Data Environments, or more recent work ascertaining Londoners views on the future of Primary Care, is a powerful tool for building clinical confidence and supporting commissioning decisions relating to innovation too.  

Having a public hungry for innovation, as well as a workforce, will support our collective appetite for risk and deliver a less paternalistic approach to healthcare delivery. 

The Health Innovation Network provides this support for local health and care systems, academia and Life Science partners so please do get in touch if we can help navigate some of these challenges. We are keen to help!

Nicola Bent, Chief Executive Officer at Health Innovation Wessex.