How Can You Innovate With Financial Constraints?

We take a look at how the NHS can innovate given it's tight budget


The idea of innovation - the creation and implementation of new ideas and practises - by its definition is relatively difficult to do on a large scale. After all, the reason that startups are seen as being the most innovative is often because their changes can be made quickly and rolled out in days or even hours. For instance, if a young app company comes up with a new app that could disrupt the marketplace, they can create it and have it live within days.

This all changes as companies begin to grow and the way they are run stops being about shouting across an office, and shifts to emailing departments heads who then communicate downwards until something is apparent to everybody involved. These new ideas often take time to work too, so a new innovation that decreases productivity by 5% in a startup with 20 employees is going to be considerably easier than an organization with thousands of employees, where a 5% loss across thousands of people can do huge damage.

Innovation is also key in product development, where companies can spend millions bringing new or updated products to market. This is not something that many companies can do to launch completely new products, with several innovations happening because of the money spent beforehand or even taking advantage of the innovation of another company. If you take Uber as a prime example - who utilize the technological innovations that were developed by the major smartphone manufacturers in order to operate - they would not exist if it weren’t for the millions of dollars spent on the development of other products.

However, how can you innovate in a large company where you can’t spend millions and even the concept of experimentation that doesn’t provide instant ROI is frowned upon? In the UK there is an organization that fits all of these criteria - The NHS.

So how could the NHS potentially find a way to innovate within such tight confines?


Healthcare and sharing have not always been synonymous with success. One of the most important elements of healthcare is confidentiality as they deal with the most secretive elements of people’s lives. It is one of the key reasons why the spread of data analytics within healthcare has been lagging behind other areas despite the considerable advantages it is likely to bring.

However, we have seen that collaboration within healthcare for innovation is something that the NHS and private companies are open to. In July 2016 Moorfields Eye Hospital in London announced a partnership with Deepmind to analyze OCT scans to help identify and prevent eye disease in the future, with Deepmind saying:

‘Our research project is investigating how technology could help to better analyse these scans, giving doctors a better understanding of eye disease. We hope this will lead to earlier detection and treatment for patients and ultimately help to avoid cases of preventable eye disease.’

Through these kinds of collaborations the NHS can gain access to technology and the best minds in order to create innovative treatment techniques and diagnostic mechanisms. It is of course important for these partners to be carefully vetted beforehand to avoid issues, but there is the potential to have a huge impact on innovation within the NHS in the future.


The NHS currently has a confusing system that is, ironically, ripe for innovation, but given cost constraints has been largely ineffectual. Many of the records used by the NHS are still paper based, which is quite a difficult legacy system. There have been attempts to change this, but with the huge costs associated with it, political will has been poor and few governments are willing to take risks.

However, although the initial investment to completely digitize the NHS will need to be considerable, it will reduce costs moving forward. There are medical records for every single patient, meaning over 64 million records need to be digitized, secured and updated - a considerable task given that many of these will contain records going back over 50 years, with hundreds and sometimes thousands of entries. These will then need to be validated as a slight typo can be the difference between life and death.

Through making everything in the NHS digital, innovation projects can be undertaken considerably quicker, meaning less cost and resources needed to complete. There is also the possibility to model more accurately, meaning that experimentation does not need to impact on services and instead can be rolled out having already been virtually tested.

Start small

One of the key elements to successful innovation is to start small, with minimal cost and minimal disruption to the entire service. Trying to launch a new innovation across an entire trust or even just a hospital can cause a huge amount of disruption and end up costing thousands of pounds and potentially even lives. The key to firstly making sure that it is done cheaply and effectively is to implement slowly in a small, controllable environment to assess viability, then slowly pushing it to other areas in order to minimize disruption and keep control over implementation.

Listen to patients

The NHS is not like a traditional company, it hasn’t been designed to make a profit and never will be. Equally, if the patient is the customer, it is the antithesis of ‘the customer is always right’. People come to their doctor to find out what’s wrong with them, not to tell the doctor what they want to have done.

However, the success of any innovation will be in how patients react to any changes made. Ultimately if a new idea cuts waiting times for surgeries, people will be considerably happier, if a new idea slows them down, even if it is for a longer term improvements, it is unlikely that it will be deemed a success by patients.

Therefore NHS trusts need to find out what their patients want and then focus their innovation efforts around it. When working within a financially constrained system, it is vital to gain buy-in from all stakeholders, and when it comes to healthcare, the patient is the biggest stakeholder of all. Simply asking people what would make their treatment more manageable or even how beds could be more comfortable, can make the difference between a ground breaking innovation and a public outcry.

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