The importance of innovation in health and social care is well-recognised. This guidance explains what innovation is and how it can be encouraged – in particular where it reduces health inequalities.
We also share some examples of good practice to help you recognise and share innovation.
We want you to tell us about the innovations at your practice so we can properly recognise your work in our assessments.
What is innovation?
We use the term innovation to include:
- invention (creating new ideas, products, services or models of care)
- adoption (using what has worked elsewhere and helping share good practice).
Both are equally important.
Enabling innovation and adoption in health and social care sets out 6 principles to help providers innovate:
- Develop and deploy innovations with the people who will use them
- Develop a culture where innovation can happen
- Support your people
- Adopt the best ideas and share your learning
- Focus on outcomes and impact
- Be flexible when managing change
About this work
This guidance builds on work that looked at how we can capture, consider and share innovative practice by NHS GP providers that aims to reduce health inequalities.
We are doing this work because our research found that the way we regulate did not always take into account the context of deprivation or recognise innovation to tackle health inequalities by GP practices in poorer areas.
The work was funded by the Regulators’ Pioneer Fund.
Our work as part of the Regulators’ Pioneer Fund identified some further key points. These provide some helpful information about evaluating innovative practice that addresses health inequalities:
- Innovation needs to be tailored to your individual practice and the needs of your population. There is no single way of successfully innovating to reduce health inequalities. Every practice is unique, and a practice needs to take this into account to have the greatest impact on its population. Every practice will be working at a different pace.
- Innovation doesn’t have to be about treating disease or illness. It may challenge the status quo and may take a different approach to managing health. For example, it may focus on improving life chances and the overall physical, mental and social wellbeing of patients.
- Developments in technology aren’t the only way to be innovative. Although technology will continue to shape new practices, sometimes advances may exclude certain groups. For example, people in more vulnerable circumstances or who are more likely to experience health inequalities, such as:
- older people
- people with particular disabilities
- people facing poverty who do not have access to digital technologies.
- Innovation doesn’t have to be proven to work to be innovative. You may not consider a new way of working to be innovative in its early stages because it has not yet been proven to have its desired impact. But early-stage innovation is still valuable: it can result in important learning and show how a practice is developing and its commitment to improvement. You need to monitor this closely to make sure the innovation doesn’t lead to unintended consequences.
- Innovation is often more successful when delivered collaboratively across a system. Consider collaborating with partners in your local area to address health inequalities. This could include other types of health and care services as well as organisations in other sectors.
- It’s not just GPs who can lead on innovation. Capacity and resourcing issues may mean that healthcare professionals or managers in the practice team are best placed to lead on innovation. You should encourage and help this.
Key points to consider
- Consider the population in your area. Do people present with particular needs? Is there a recurring issue you could address? Are there particular poor outcomes that need addressing, or that fall below national or local benchmarks?
- Work with your patients to determine how best to resolve the issue or support them. If it’s difficult to reach out to particular groups, work with community leaders or charities that have built up trust and a relationship with the community.
- Does your practice population include groups of patients in particularly vulnerable circumstances and therefore less likely to receive support from health and care services? Think about why this is and how your practice can influence this.
- Think about how you can work with partners in your local area to deliver, monitor and review innovation. This includes how you might work within your integrated care system to address health inequalities at both place and neighbourhood levels.
- Are you aware of other providers that have managed to innovate and improve? Consider sharing and learning from one another, remembering that what works in one provider may not work in another. Personalisation and autonomy are key in developing innovation in your own practice.
- Think about how you can embed and sustain your innovation over time.
- Before you start, plan how you will measure the success of innovation. You will need a baseline to do this before you start to introduce the innovation. It may take some time for the innovation to have an impact on people’s outcomes, which might be quantitative or qualitative. But there may be other measures that you can use, for example feedback from patients or uptake of particular services.
- Are there any metrics at primary care network or GP practice level that you could use to help measure the effectiveness of an innovative solution after implementing it? For example, you could check your GP patient survey results for any improvement in patient experience, or use the primary care network dashboard to check any improvement in patients’ access to online appointments or prescriptions.
We encourage you to share any examples of innovation in your practice with your CQC inspection teams.
Although innovation is important, you need to make sure you are still delivering a safe, effective, caring, responsive and well-led service.
To help you to recognise and share innovative practice with us, we asked participating GP providers in our research to tell us about their successful innovation to address health inequalities. We recognise that others may be doing similar work. But we want to hear about innovation in all forms.
At the time of writing, all the featured GP practices were delivering a good standard of care.
The Brimington Surgery
The Brimington Surgery secured funding through its primary care network to carry out staff training and get involved in the Pride in Practice programme to support the LGBT+ community to have better access to GP services.
The practice revised its policies and language to be more inclusive of LGBT+ people. This included:
- revising the whole patient journey from first contact
- providing specific and informed patient-centred care
- prescribing and onward referrals.
The practice also:
- supported staff to challenge any homophobic or transphobic language or actions
- adapted the patient record system to include gender neutral titles
- approached the electronic records provider to explore if additional titles could be added to the system
The Living Well Partnership
The Living Well Partnership recognised that some patients found it difficult to use the eConsult system, including those who were visually impaired, those who had a learning disability or whose first language wasn’t English.
The practice trained its patient services team to support patients to complete eConsult requests. The team could submit requests on their behalf, with telephone triage as a back-up when this was not possible.
Once it had patients’ contact details, the practice provided information about additional services such as smoking cessation. This made sure that all patients had access to their GP. Reception staff and the patient participation group helped design and deliver this approach.
The practice still used other routes for patient triage (such as by telephone) and added an alert to patients’ notes to take account of any tailored adjustments and communication needs.
Brigstock Medical Centre
Brigstock Medical Centre identified that it was not meeting HbA1c (average blood sugar levels) targets for managing diabetes, and the practice had over 1,000 registered patients with this condition. Feedback from patients suggested they were finding it challenging to sustain change and take control of their condition.
The practice introduced 4 daytime group consultations a week for patients living with Type 2 Diabetes. These were run by a nurse prescriber and a pharmacist prescriber, and supported by non-clinical facilitators. Group consultations replaced annual reviews and follow-up appointments for more than 600 patients who attended. The sessions worked with patients to understand their results. They then moved on to address the underpinning psychosocial issues that may have acted as barriers and looked at how patients could support each other to take control and manage their diabetes.
This approach changed through the pandemic to respond to patients’ needs, including offering group consultations by videoconference. The practice continues to offer hybrid sessions.
Spring Hall Medical Practice
Spring Hall Medical Practice supported St Augustine’s Community Centre in its work setting up a ‘health befriender scheme’ for asylum seekers and refugees across GP practices in central Halifax.
This helped these patients navigate the NHS and access help and support for their health needs. The scheme matched up new arrivals to the community with asylum seekers and refugees who had settled in the local community to support them with booking appointments and getting to consultations.
It also provided support in other areas depending on need, such as helping people to apply for bus passes, arrangements for household utilities, navigation and reading maps.
National Healthcare Inequalities Improvement Programme (NHS England)
Supporting innovators (The Academic Health Science Networks Network)
Innovative models of general practice (King’s Fund)