Test beds and NHS innovations – will the risk-taking pay off?

Lucia von Bredow

11 June 2015

The Five Year Forward View has started to take shape, and the recent launch of the NHS Test Beds programme has really set the tone for the NHS in the 2015 post-election landscape. 

The programme acknowledges that although ‘there is no shortage of innovation in the NHS’, it has not ‘diffused as quickly as, or had the impact that, has been seen in other industries - particularly in reshaping how clinical services are delivered’. It thus seeks to address that issue head-on, across three main areas. Firstly, by attempting to prevent organisations within the NHS from working in silos such that innovations are introduced in isolation from each other and from critical infrastructure. Secondly, by strengthening the (generally inadequate) evidence-base for the effects of innovations in real world clinical conditions, allowing the true benefits to be determined. Finally, it is noted that innovations are often introduced on top of existing working practices and infrastructure rather than in place of them, typically increasing cost but not value. In contrast the programme aims to improve health and healthcare outcomes at the same or lower overall cost, producing high-value innovations, by combining technologies with innovations in service delivery. 

It will be interesting to see how far the programme, which is open to expressions of interest until the 12th June, will go to fix the perceived barriers to innovation: will the successful tenders be visionary enough to make a tangible difference? The test bed scheme certainly looks promising; it hopes to encourage ‘combinatorial innovation’ – or the fusing of different types of innovation – of technology, workforce, patient engagement or digital channels. The examples cited are digital technologies to support patient self-management, or to exploit existing health data in new ways.

In addition, unlike existing programmes focusing on early-stage innovation (such as those commissioned through National Institute of Health Research schemes), or those that are designed to scale-up innovations (like the Innovation Accelerators), it will provide a unique platform for real-world assessment. Through extensive networks of local commissioners and providers, Academic Health Science Networks (AHSNs), larger town or city conurbations, or indeed rural areas with specific needs, it will be possible to test the innovations in diverse live clinical settings. Thus, the emphasis is on ‘conducting pragmatic, reasonably rapid (i.e. 2-3 years) yet robust trials of packages of innovations that offer the opportunity to fundamentally improve outcomes and efficiency of clinical services’.

Of particular interest is that one test bed will be exclusively given over to an ‘Internet of Things’ (IoT) approach: the facilitation of connected networks which hope to enable data sharing, here in a healthcare context. However, critics have identified that ‘integrating data from devices with heavily-secured patient record systems, as well as concerns about overloading professionals with data’ may prove problematic. But as a recent Guardian article reports, the healthcare professionals pioneering such technology say that the key is to manage the data generated by patients. The article gives an example of Bradford GP Dr Shahid Ali, who noted that 'a lot of GPs have got the idea that technology makes their lives more difficult…I wouldn’t use any technology that made my life more difficult. This is about proactive management and exception management'.

With the test beds partnerships due to be finalised in autumn 2015, and designation to take place by the end of the year, we should start to see the results of the chosen projects in the next few years. Should this scheme prove fruitful, it could provide an exciting springboard for innovation in the NHS. I look with interest to see how successful it will be in driving the aims of the Five Year Forward View, and am keen to hear what other initiatives will be proposed to complement or facilitate this new vision. 


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