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.
Effectiveness
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:
- AF Demonstrator Site Programme (see case example – add hyperlink)
- AHSN network
- Q Exchange
- Test beds programme.
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:
- Improving access to general practice
- AHSN Network Innovation Exchange work on specific innovations.
Practical considerations for use
| Method or Lever | Stage of development * | Audience and scale ** | Resources needed | Timeframe |
| Demonstrator sites | Prototype/testing and spread | National, regional or local | Funding and local engagement/capacity, Evaluation support | Variable depending on nature of intervention |
| Rolling out | Prototype/testing and spread | National, regional or local | Funding and local engagement/capacity, Evaluation support | 1-2 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