Approaches to Spread and Scale
A new and unique resource to help leaders select the most appropriate methods and levers to enable the spread and scale of innovation and improvement is now available, details here and summarised in this blog and sketchnote below.
Leading the Spread and Adoption of Innovation and Improvement: A Practical Guide
Would you like to increase the scale and pace of the spread and adoption of innovations and improvement to aid recovery? A recent 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.
A great way to get an overview of the Guide is to watch the video recording of the introductory webinar available here. The slide set is available here. A blog here containing summary of the chat box conversation, answers to questions raised that could not, due to time, be addressed in the webinar and feedback shared on the Guide.
Read how the ‘Leading the Spread and Adoption of Innovation and Improvement: A Practical Guide’ can help in practice based on the experiences of the winner of the draw for a free advisory session.
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.
This video gives an overview of the Guide.
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 linked blogs and 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. Read more in this blog.
- Individual – the perspective of the individual – patient, carer, staff member – is pivotal to enable behaviour change. Read more in this blog.
- Benefit – focus on the benefit rather than the innovation, the ‘why’ not the ‘what’. Read more in this blog.
- Adopter focus – support adopters so they have a sense of agency and feel energised about the work. Read more in this blog.
- Networks – build communities, energising and connecting individuals. Read more in this blog.
- Learning – build a learning system and habit of learning, sharing with and seeking knowledge from others. Read more in this blog.
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 Systems 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 systems convening available in our short recording here, and the blogs below and in detail in the Guide.
Blogs, videos and case studies on Spread, Adoption and Systems Convening
Read more in our blogs:
- A New and Unique Resource to help you Spread and Scale Innovation and Improvement
- How behavioural science can help us spread and scale innovation and improvement
- How the FutureNHS virtual workspace enables spread of improvement and innovation through collaboration and learning.
- Leading the Spread and Adoption of Innovation and Improvement: Insights through the national Fractional exhaled Nitric Oxide (FeNO) testing programme
- Introducing Systems Convening Practices into a Project Management Environment – 3 lessons
- Systems Convening in Practice – a Chat with Madi Hoskin
- How the ‘Leading the Spread and Adoption of Innovation and Improvement: A Practical Guide’ can help in practice
- 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
- How behavioural science can help us spread and scale innovation and improvement.
- Systems convening in practice – a chat with Madi Hoskins, video (19 mins)
- Systems convening: its role in the spread of innovation and improvement, Q community zoom, video and slides
- Systems convening and the spread and adoption of innovations and improvements, short video (4 mins)
- The New Mindset and the Seven Spread and Adoption Principles Explained
- 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
Case Study from AHSN network
Improving Detection and Treatment of Atrial Fibrillation Across England, April 2021 details here
Further reading
Review of spread and adoption approaches across the AHSN network. 2021.
Systems Convening: A crucial form of leadership for the 21st century 2021
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: 30 March 2023