Leading the Spread and Adoption of Innovation and Improvement: A Practical Guide – New Publication September 2021
Would you like to increase the scale and pace of the spread and adoption of innovations and improvement to aid recovery? A new NHS England and Improvement publication produced by the NHS Horizons team: ‘Leading the Spread and Adoption of Innovation and Improvement: A Practical Guide’ is now available to help you achieve this.
Why we need this guide
Enabling spread and adoption of innovation and improvement in our complex, inter-dependent world is difficult. The NHS is a complex adaptive system, continually changing and adapting, which means we cannot completely understand it simply by knowing about the individual components. Many innovations are complicated or complex, so their spread and adoption in this context is not a simple predictable, process.
What this guide offers
This guide offers seven interconnected principles and a way of leading to apply them in practice, developed from knowledge and experience. The practical tools and methods, and case studies pages will help you apply these to your work along with the further information pages which provide a depth of detail and knowledge.
The content is practice focused; it has been tested via multiple presentations and prototype demonstrations at local, regional and national levels and modified based on the feedback shared with us. We send our thanks to the many people in the NHS and beyond who have given their time and expertise to share their feedback.
Who the guide is for
The guide is aimed at local and national system leaders in all sectors, particularly leaders of large-scale change and those with responsibility and interest in increasing the spread and adoption of innovation in practice.
Where the guide will be helpful
This guide is applicable for all levels; local, regional and national, and settings where the spread and adoption of complex change is needed. It sits alongside and supports existing activities e.g. programmes, such as the NHS Innovation Accelerator, organisations, e.g. AHSNs, and models, such as the NHS Change model and can be used to inform planned and existing work.
We would love to hear your feedback about the guide, and how you will or have used it. Send a tweet to @DianeKetley @HorizonsNHS, #NHSSpread. If you prefer email, get in touch at England.si-horizons@nhs.net.
How to increase spread and adoption?
We offer seven interconnected principles (shown in the diagram above), which are important aspects to consider for spread and adoption. These principles are summarised below with more detail and explanation in the Guide.
- Complexity – understanding complexity and the implications for your work. Spread and adoption in health and care is often not straightforward, but an activity that requires managing many interdependencies. Read more in this blog
- Leadership – an enabling leadership style – to give people the space to connect and engage – is needed
- Individual – the perspective of the individual – patient, carer, staff member – is pivotal to enable behaviour change
- Benefit – focus on the benefit rather than the innovation, the ‘why’ not the ‘what’
- Adopter focus – support adopters so they have a sense of agency and feel energised about the work
- Networks – build communities, energising and connecting individuals
- Learning – build a learning system and habit of learning, sharing with and seeking knowledge from others
Relational, interpersonal elements of spread and adoption – looking at how people can work together – is a common thread within each of the principles.
More information on the seven interconnected principles available in this introductory blog, our short recording here, in the blogs below and in detail in the Guide.
The model of System Convening involves:
- Matching approach to spread and adoption with the complexity of the situation
- Applying the seven principles in practice
- Providing enabling activities delivered by a team or a number of people
- All levels in the system
More information on the model of system convening available in our short recording here, and the blogs below and in detail in the Guide.
More about spread, adoption and system convening
Read more in our blogs:
- How the Seven Spread and Adoption Principles Work in Practice: the Continuing Healthcare Improvement Collaborative case study
- Planning For Spread and Adoption From The Start: A Novel Model For Success
- Understanding and Working with Complexity
- ‘That’s what I do’ – voluntary partnerships, complexity and an activity named system convening’
- ‘Adaptive Spaces’ for an emerging future
- Why an ‘Enabling Leadership’ Style is Needed for Innovation, Spread and Adoption
- The Importance of Local Adaptation in Innovation Spread and Adoption
- COVID-19 Crisis: Creating Adaptive Spaces and Enabling the Spread and Adoption of Innovation
- COVID-19 – A Complexity Leadership Response
- Adaptive Spaces, Networks…. and a Challenge Called Spread
- Spread and Complexity in the NHS
- Do We Have the Three Types of People Needed for Scale and Spread in the NHS?
- Three theoretical lenses to inform spread
- Complex systems, networks and adaptive spaces
- Moving to Action: Spreading and Scaling Change Session at Expo 2019
Case studies
These case studies illustrate how the 7 spread and adoption principles and the model of system convening apply in practice.
- A winning partnership – System Convening combined with Programme Management improves patient experience: full video here, short video here and blog here
- A winning combination: programme management with system convening to develop and spread the BASIC STEP tool in North West Ambulance Service (NWAS): video here and blog.
- Spread, adoption and systems convening: the Welsh Ambulance Service Trust (WAST) falls framework: video here and blog ‘Complexity and System Convening – a lightbulb moment.
Videos
- Mary Uhl-Bien in Conversation: COVID-19, complexity leadership and spread of innovation
- What is Adaptive space? a Brief Introduction by Gareth Evans [ 2 mins]
- Adaptive Space in Action by Matthew Mezey [4 mins]
- Adaptive space – Overview of the work of Mary Uhl-Bien by Diane Ketley [4 mins], and related blog with links and details ‘Adaptive Spaces’ for an emerging future
- The New Mindset and the Seven Spread and Adoption Principles Explained
- System convening and the spread and adoption of innovations and improvements
Case Study from AHSN network
Improving Detection and Treatment of Atrial Fibrillation Across England, April 2021 details here
Further reading
- Systems Convening: A crucial form of leadership for the 21st century
- Care Quality Commission Enabling innovation and adoption in health and social care: Developing a shared view. 2021.
- Nuffield Trust Achieving scale and spread. 2020.
- The Health Foundation. The spread challenge. 2018
- Innovation Unit and Health Foundation. Against the odds: Successfully scaling innovation in the NHS. 2018.
- King’s Fund. Adoption and spread of innovation in the NHS. 2018
- Nuffield Trust. Falling short: Why the NHS is still struggling to make the most of new innovations. 2017.
- Braithwaite, J. Changing how we think about healthcare improvement, BMJ 2018; 361: https://doi.org/10.1136/bmj.k2014
Get in touch
This page will be updated as our thinking progresses. Any comments or questions please contact Diane Ketley or via @DianeKetley
You can also follow the hashtag #NHSSpread on Twitter.
Page last reviewed: 06 October 2021