Spread approaches

Approaches to Spread and Scale

The methods available to system and policy leaders to support spread and scale of innovation and good practices for improvement

The spread and scale of innovation and improvement is a huge and long standing challenge which we need to meet to successfully deliver healthcare. To help you achieve spread and scale we have collated all the ways to do this into seven approaches listed below:

Click the links above or view the sketchnote below for details of these approaches.

How this collation of approaches will help you

This collation of spread and scale approaches is intended to support you in early and explicit consideration and selection of the most appropriate method(s) for your work. Many factors influence this decision including the nature of the innovation or improvement and the specific context.

Who will find this collation useful?

  • System and policy leaders working nationally and locally
  • Leaders enabling spread and scale of innovations and improvements (interventions)

About this collation

  • A collation of methods and levers to support the spread and scaling of innovation and improvement offered as seven approaches
  • The approaches reflect different characteristics of the methods or levers such as varying levels of central standardisation and focus on extrinsic or intrinsic motivation.
  • The collation is relevant to interventions which have sufficient evidence to justify their spread. Where further evidence or proof of concept is required, this should be undertaken prior to spread and scale activities

How to use this collation

First consider:

  • Nature and characteristics of the intervention to spread or scale e.g. is it simple, complicated or complex (details)
  • Audience being targeted – size, characteristics, motivators (extrinsic, intrinsic), existing energy for change
  • Timescale
  • Resources available

Then review the seven approaches looking at the descriptors of the approaches including their effectiveness and limitations. Within each approach there are individual methods and levers with their details, links to examples and a table of practical considerations.

Often a combination of methods and levers is needed used concurrently or sequentially. Case examples illustrating this combining of methods and levers, based on interventions and programmes that have achieved spread, are available (see below).

Successful application of these methods and levers in practice requires understanding how to enable change including the skilful application to each specific context. Appropriate plans for evaluation and communication are essential.

Case examples

Case examples illustrate the combinations of methods and levers that can and have been used in different settings and contexts.

When to use this collation

  • Use as early in your as possible and appropriate, ideally during initial planning.

Where in the system this collation is applicable

  • At national, regional or local level, as indicated in the practical considerations stated for each method or lever

How does this collation link to other models and frameworks?

This summary intends to complement other frameworks and conceptual models and to support early consideration of the approaches available to spread and scale. For innovation, such early planning can help the progression of new technologies through the innovation pipeline.

These methods can be considered in conjunction with frameworks such as NASSS which can be used to predict or evaluate the success of a technology supported health or care programme. For improvement, these approaches help inform the spread and adoption component of the NHS Change Model and should be applied considering the 7 interconnected principles for spread and adoption.

How this collation was developed

This collation was led by NHS Horizons and the Innovation, Research and Life Sciences team at NHS England (NHSE). Wide and essential input was provided by colleagues within NHSE, the wider NHS (local and regional including AHSNs and the AHSN network) and wider partners.

Additional Resources

You may find these resources useful to inform your thinking and planning:

Feedback and comments

We welcome your feedback especially suggestions for improvement, please send any comments to mlcsu.spreadcommunityofaction@nhs.net.