Richard Barker: How can academic health science networks (AHSNs) influence GPs to spread innovation?

As independent contractors, GPs cannot be instructed to take up innovation. They will adopt innovations that they can see will benefit their patients and also their practices in terms of finance or efficiency. They can be given financial incentives, but there is a limit to the funds available and Quality Outcome Frameworks (QOFs) have historically been used to ensure that current good practice is as universal as possible. Today’s report from Nesta and CASMI has confirmed that in considering adopting an innovation, GPs have very limited time and resources. However, some practices are ahead of the curve at adopting certain types of innovation (our report looked at drugs, technologies, and practices). While our research didn’t uncover any “serial adopters” who take up all innovations rapidly, it did reveal “technophilic” practices that tend to adopt a cluster of IT innovations more readily than others. It is well accepted that the uptake and diffusion of innovation in the UK lags behind what is desirable and what many other countries achieve. The 2011 report Innovation Health and Wealth set out a number of recommendations to speed the process, including the formation of academic health science networks (AHSNs)—regional networks created to develop solutions to healthcare problems and get existing solutions spread more quickly by building strong relationships with their regional scientific and academic communities and industry. They have been specifically formed to drive innovations in their geographical patch. How can AHSNs work with early adopters such as the ones identified in this report to accelerate the uptake of innovations? We need a practical, testable approach to the adoption problem, which is now widely syndicated as a priority for the NHS. I believe the AHSNs could take a lead, as follows:

  • Identify the top three to five clinical priorities for their networks.
  • Translate these into outcome measures, and set them as primary goals for the network.
  • Identify the innovations most relevant to achieving these outcomes, and engage with relevant clinical opinion leaders and patient organisations on both the outcomes and the role of the innovations.
  • Develop the clinical and business case for the innovation, based on outcome improvement/additional cost.
  • Engage with the clinical commissioning groups (CCGs) to secure support for the case, and ideally CCG advocacy for it.
  • Identify early adopter GPs to become ”innovation leaders” (some payment may be desirable for the time spent, as well as recognition for achievement).
  • Set up the network infrastructure needed for opinion leaders, innovation leaders and patient representatives to secure GPs’ commitment to the outcome goal.
  • Provide the briefing materials, training, and support to ensure the commitment of the GPs turns into effective implementation.
  • Regularly publish progress on implementation and on the outcomes linked to it.
  • Hold recognition events for the implementation leaders and highlight their achievements in any AHSN/NHS communications.

The report also contains a set of tools that can be used to engage GPs who are at different stages of the adoption process. GPs, along with other practitioners, patients and every stakeholder involved in primary care should feel empowered to drive forward innovation, and championing early adopters would be an important step towards this. Richard Barker OBE, director of CASMI. Competing interests: Richard Barker is chairman of the Health Innovation Network, the AHSN for South London.