Piloting and rolling out

Piloting and rolling out

Methods that involve piloting and rolling out enable an increasing number of sites to adopt an innovation or improvement by sharing and applying the learning gained from use in earlier sites.

Two methods or levers have been identified in this category and are summarised below.


The effectiveness of these methods will vary depending on context, but key strengths of methods which utilise piloting and rolling out include: 

  • Often involves funding to small number of NHS sites with purpose of proving real world efficacy/understanding implementation challenges for specific interventions – learning can be used to support adoption elsewhere or to support national value for money assessment by NICE.
  • Can provide effective mechanism of building evidence in a real world setting to generate evidence required for spread[i]
  • If accompanied by an evaluation, barriers and enablers can be identified to help inform scale and spread issues

However, there will be limitations to these methods which may include:

  • Additional follow-on support or alternative may be required to fully achieve anticipated  level of spread and sustainability

Methods and Levers

Demonstrator sites

Learning gained from supported selected demonstrator sites is spread to wider audience. Examples include the:

Rolling out

An innovation or improvement is tested in a specific setting, followed by a deliberative process to spread the intervention to multiple settings, can include real world validation. This can also involve honing the intervention or determining what aspects are essential or core and which are discretionary or adaptable. Examples include:

Practical considerations for use

Method or Lever  Stage of development * Audience and scale ** Resources needed Timeframe 
Demonstrator sites  Prototype/testing and spreadNational, regional or localFunding and local engagement/capacity, Evaluation supportVariable depending on nature of intervention
Rolling outPrototype/testing and spreadNational, regional or localFunding and local engagement/capacity, Evaluation support1-2 years

* Stages of intervention development – Ideation, Proof of concept, Prototype/Testing, Spread

** Audience and scale – national/regional/local, targeted by clinical speciality / product/ problem

[i] Department of Business, Innovation and Skills and Department of Health. Accelerated Access Review: Interim Report. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/471562/AAR_Interim_Report_acc.pdf