Collaboration and governance

Collaboration and governanceOn average, it takes a staggering 17 years to implement a proven healthcare innovation into standard medical care.[1] When you consider the vast scale and complexity of the NHS, this is understandable. Currently in England alone, there are 211 clinical commissioning groups, 156 acute trusts, 56 mental health trusts, approximately 8,000 GP practices and 800 independent sector organisations providing care to NHS patients from over 7,000 locations.[2] Think of launching new software at your company – all the training that is involved, new policies may need to be written, approval and consultation has to be sought from different stakeholders. The process is only intensified in a system so large and fabricated from a multitude of different organisations each with their own practices.

Whilst it is understandable that it takes time for innovations to be implemented into standard medical care, this does not mean we should just accept it. In the 17 years between something being considered a proven innovation and it being fully implemented into standard medical care, countless patients are missing out on innovations that can improve their quality of life.

In such a large system, collaboration and governance, Aurora’s fifth Access All Areas dependency, is essential to improving access and speeding up the implementation of innovation. There are already programmes in place with this objective – UCLPartners and The Health Innovation Foundation co-host the NHS Innovation Accelerator (NIA), which aims to create the conditions and cultural change necessary for proven innovations to be adopted faster and more systematically through the NHS, and to deliver examples into practice for demonstrable patient and population benefit.

An example of one such innovation is Dharmesh Kapoor’s EPISCISSORS-60 – these patented fixed angle scissors prevent human error in estimating episiotomy angles during childbirth. If the angle is not correct, standard practice episiotomies can cause obstetric anal sphincter muscle injuries which can lead to anal incontinence – and rather understandable this could greatly impact the quality of life of a new mother, if not the rest of her life. The innovative scissors are already being used in 15 UK hospitals and with the NIA programme this number will continue to grow.

Academic Health Science Networks are just one method of collaborating for improved access to medicines. In the healthcare system, there is a tendency to avoid collaboration either due to concerns over compliance or past relationships. There is guidance on joint working between the NHS and pharmaceutical companies set out in the Code of Practice issued by the ABPI (Clause 20). In terms of complicated past relationships, patient groups can act as ‘third-party glue’. Such groups often have a strong grasp of the landscape, and the differing priorities and pressure points facing all the key players. Therefore, they can offer a coherent evaluation of the situation, and perhaps serve as an honest broker. The ABPI code of practice also has guidance on such relationships (Clause 27).

By reflecting on your approach to collaborations and partnerships to date, you can move towards effective collaboration:

  • What can be learned from the successes of past collaborations?
  • Where mistakes have been made, are you able to acknowledge them to move forward?
  • Which parties should you consider reaching out to? What would need to happen to enable a partnership to develop?
  • Consider whether you are willing to defer to a third-party facilitator. What beliefs, ego, or agendas might you have to give up?
  • Consider whether you can bring integrity to the table and sustain it. What mechanisms can build transparency and honesty into the relationship?

To find out more about this dependency and the other dependencies, read our Access All Areas paper, ‘Creating opportunities for improving patients’ access to medicines’, available for download here.

[1] Who We Are, UCLPartners
http://uclpartners.com/who-we-are
[2] Key Statistics on the NHS, NHS Confederation, March 2015
http://www.nhsconfed.org/resources/key-statisticson-the-nhs

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