Health and Wealth in Northern Ireland: Capitalising on the Opportunities

The need for an aligned policy mindset is compelling and urgent. This report should be considered collectively by Departmental leaders at the highest level through a series of interdepartmental meetings or shared policy discussions, rather than separately in individual departments or solely by DHNI. 

At the earliest stage in these discussions, leaders should agree and develop their shared vision, mission and purpose of the ecosystem including agreement of its defining operational characteristics.

I recommend the establishment of a Joint Committee, and/or a standing cross-departmental forum for R&D, health and care innovation adoption and spread that includes all the key government departments and also the chairs of each of the Health Board Innovation and Technology Sub Committees (see recommendation 7).

This forum would be served by recognised and accountable executive leadership with absolute clarity on roles and responsibilities. The forum would be tasked with establishing an effective process of priority setting, investment and would have the responsibility for overall strategy (including considering regulatory reform), assurance of delivery and setting/role modelling the appropriate collaborative culture and behaviours.

To inform the work of the standing forum I recommend the development of a cross-cutting, key innovation metrics dashboard that provides data to the forum on issues such as: numbers of patients engaged in clinical trials, speed of establishing trials, roll out of specific priority innovations, interoperability of data, development of clinical academies roles, jobs associated with new innovations, university-based spin out companies etc. The dashboard would be informed by a local version that covers each health trust to reveal variability across Trusts and help to spread best practice in adoption and spread.

Having created the positive mindset to embrace innovation as the key means to transform care and deliver added value for every pound spent, it is important to improve the coherence and efficiency of the current central operating capability.

I recommend supercharging and refocusing the current centralised R&D support but adding to its central support for innovation adoption and spread including the requirement for the development of standardised pathway(s). This should be coordinated through a single senior leadership team/group at NI level.

There is a fundamental requirement to base the new approach on shared and appropriate access to data and analytics. I recommend that the digital strategy for NI explicitly sets out and embraces how it directly supports R&D, innovation adoption and spread, and delivers that functionality for all component parts such that there is a single version of the truth available and an ability to set shared measurable objectives.

This should also serve to speed up the ability to attract and deliver clinical trials and innovation pilots, which in turn can fuel the recruitment of more higher quality clinicians and researchers (as evidenced by the NW SHA initiative to speed up the establishment and delivery of clinical trials).

It is imperative that Health and Social Care Trusts and AIPBs are connected more directly to health and care innovation adoption and spread. I recommend that every Trust Board is asked to set up a Health and Care Innovation and Technology Sub Committee that oversees the activity of the organisation in these areas. The sub committees would be responsible for the production and oversight of their local key innovation metrics dashboard. They would also serve to align digital strategies with service innovation, improvement and transformation.

It is essential that this area is given a higher priority for leaders within the Health and Care system, so I recommend that R&D and innovation adoption and spread is built into the objectives of senior general and clinical managers in the Trusts (and AIPB chairs); and that Health Trusts and AIPBs seek to recruit executive and non-executive leaders/members with wider industry and innovation experience.

It is clear that resources are limited and required to fund diagnostic interventions and treatments, however the targeting of a small amount of resource in this area will have a high return on investment through improved productivity, potential job growth, and inward investment (e.g., in clinical trials and clinical academic posts).

I recommend that a cross-departmental, development budget be identified to support the implementation of this report and its recommendations, should they be accepted. Once agreed, I believe that its value should be evaluated by setting goals for a return on investment being delivered within an agreed timeframe. If successful, as I believe it would be, this will build confidence to invest further on a permanent basis

In order to move swiftly, I recommend that ecosystem leaders set out an organisational development programme that initially draws on external advice (Yorkshire and Humber AHSN have already engaged informally in this process) and commit to building this new ecosystem with a learning culture, focused on continuous improvement