Scaling innovation within healthcare systems: practical considerations

Practical guidance to support the adoption and scaling of proven innovations in healthcare.

3 August 2023

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This guide comes in response to member feedback on challenges to innovation in the NHS. It provides practical pointers for innovators and system decision-makers on how to successfully adopt and scale proven innovations. The guide has been endorsed by the AHSN Network.

About this guide

  • This guide is based on extensive research and interviews with NHS Confederation members. It identifies learning from case studies that have successfully adopted and scaled innovation.

  • Each section highlights key issues to consider when adopting or scaling a proven innovation, to help ensure success.


  • Innovation is happening in pockets across the healthcare system.
  • Innovations can reduce operational pressures and increase the efficiency and effectiveness of healthcare delivery, when embedded and implemented successfully.
  • The inability to scale proven innovations is a widely acknowledged barrier to unlocking the full potential of innovations within the healthcare system.

Innovation adoption: three core pillars

There are three core pillars of activity for innovators and system decision-makers to consider when adopting a proven innovation:

1. Understand

If you are an innovator, aim to understand the specific needs of the local area and/or NHS organisation.

If you are a system decision-maker, aim to understand local population needs and the help available to support innovation adoption.

2. Engage

Both innovators and system decision-makers should engage early with the entire ecosystem of stakeholders involved in the innovation decision-making, design, implementation and use, including gathering feedback on whether the idea is a viable solution to the problems being faced.

3. Future-proof

Both innovators and system decision-makers should create a plan for funding implementation and sustained adoption to embed the innovation in such a way that it can be sustained beyond initial investment.

The role of innovators and system decision-makers

Innovators: Develop innovations that will benefit the healthcare system and patient care.

System decision-makers: Set up the mechanisms to adopt and embed innovations that benefit the healthcare system and patient care.


Local problems, support options and links with existing work need to be fully understood to help ensure successful adoption.

Innovators are encouraged to:

  • Form a clear understanding of the local capacity and true problems being faced by the local area.
  • Understand the specific challenges arising during the adopting and scaling process and work collaboratively to overcome them.
  • Find ties to national and local political priorities.

System decision-makers are encouraged to:

  • Ensure the proposed innovation will solve a problem truly being faced by the system.
  • Identify national bodies and/or skills from the innovator that can support with adoption and scaling.
  • Understand whether the innovation can complement existing programmes based on strategic priorities.

Case study: Community diagnostic centres (CDCs)

CDCs are a one-stop shop for checks, scans and tests that aim to bring earlier diagnostic tests closer to home for patients. To be successful, CDCs require an in-depth understanding of local population needs to identify the most appropriate location and services.


Early and continued engagement with the entire ecosystem of relevant stakeholders helps secure buy-in for the idea.

Working together, innovators and system decision-makers are encouraged to:

  • Schedule regular touchpoints with all stakeholders involved in the adoption and scaling work to secure buy-in and gather feedback.
  • Engage with all stakeholders that will be involved in project delivery to support with rollout when the idea is in place.

Case study: CAR-T (chimeric antigen receptor T-cell) therapy

CAR-T therapy involves reprogramming a patient’s immune system cells to target their cancer and requires specialist techniques in cell handling. This therapy first requires an understanding of local capacity and expertise to carry out the cell handing.


Financial incentives that support uptake and resourcing to properly embed innovations help ensure long-term success.

Working together, innovators and system decision-makers are encouraged to:

  • Consider funding resources to support implementation and transformation.
  • Set up financial incentives that are aligned to supporting innovation uptake.
  • Create a plan for how to continue to be funded/self-fund once initial funding runs out.

Case study: Fractional exhaled Nitric Oxide (FeNO) testing for the diagnosis and management of asthma – delivered by the AHSN Network

FeNO tests measure the amount of nitric oxide in exhaled breath, indicating allergic inflammation in the airways. Alongside a clinical history and other tests, FeNO can contribute to a faster and more effective asthma diagnosis and can monitor patient response to treatments. Historically, the test was only performed by hospital services, but has started to be introduced to primary care.

Developing Barnsley CDC in the Glass Works

Barnsley Hospital NHS Foundation Trust developed a CDC in the Glass Works, a shopping and leisure centre in Barnsley town centre with ample access to parking. The site offers appointments for phlebotomy, ultrasound, breast screening (mammography), X-ray and DEXA (bone density) scanning.


Download the PDF for an editable checklist of actions to support the adoption and scaling of a proven innovation.