Since its launch in July 2015, the NHS Innovation Accelerator (NIA) has supported innovators to scale their high impact, evidence-based innovations to an additional 1,432 NHS sites across England and to raise £45m in external funding.

The NIA is an NHS England initiative, delivered in partnership with the country’s 15 Academic Health Science Networks (AHSNs) and hosted at UCLPartners. Created to support delivery of the Five Year Forward View, this national accelerator provides real-time practical insights on innovation scaling to inform national strategy, and in its first year - according to an independent evaluation - saved England’s health and care system over £12m.

The NIA’s unique dual focus offers personal development for individuals (or ‘Fellows’) with bespoke support to spread an innovation; recognising that both are critical to scaling in the NHS. To date, the NIA has supported 36 Fellows to spread 37 innovations - including digital, medtech, workforce and models of care - all of which have been through a rigorous selection process involving patients, clinicians, multiple government health agencies, NHS England, and AHSNs. Fellows come from a variety of backgrounds; some are practicing or former NHS clinicians, some work for SMEs or large corporates, some are academics or from third-sector organisations - one is even a former police officer! The one thing they all have in common is their dedication to spreading innovation for the benefit of patients and NHS staff, and for sharing their real-world insight with colleagues across the system.

So what have we learned about accelerators?

Reflecting on what contributes most to the success of the NIA and drawing on its independent evaluation, I would select five critical elements.

Selection: There’s a huge amount riding on the people and innovations you have selected - the brand of the accelerator (and its partners), the likelihood of supporters giving their assistance, and of innovations being adopted.

Innovation adoption is a social process; patients, clinicians and commissioners need to be able to engage with the representative of an innovation, regard him/her as credible, trustworthy, considerate of their time, etc. At one of the NIA interviews, a Clinical Director set her selection bar as: ‘Bearing in mind how busy I am, would I give up half a day to help this person?’

In selecting the right people and innovations, it is critical to involve intended users and decision makers, particularly patients and clinicians. To be selected on the NIA, we also require confirmation that users - particularly patients - have been involved in the design and testing of the innovation.

Bespoke support: Every Fellow brings a unique set of skills and experiences to the NIA and every innovation faces specific barriers and opportunities.

I decided – (rightly or wrongly - the jury is still out) not to launch each NIA cohort with a five-day immersion into all things NHS, health innovation, business models, etc. I was concerned that a standardised learning experience would render only a percentage of the content relevant to each Fellow.

Instead, the NIA is organised around 12-week sprints, where we meet with Fellows individually to hear about their progress, challenges, aspirations, and help them navigate the right support at the time when they need it most perhaps via a specific mentor, another NIA Fellow or an AHSN. This could mean using their bursary, or potentially organising a discretionary workshop, if a few Fellows are experiencing similar challenges.

Patient involvement: is critical for engaging with the NHS and for successfully scaling innovation.

We recruited patients for our selection processes and governance of the accelerator from the outset. We also run ‘test your scaling strategy’ sessions for NIA Fellows early on, so that patients can provide advice and feedback on Fellows’ hypotheses and intended approaches. Feedback from patients has heavily influenced, and in one case completely changed, Fellows’ scaling strategies.

Patients and charities have a far more powerful voice in influencing policy change and senior decision makers, far exceeding that of a lone innovator or company.

And they are the life blood for innovators. Trying to scale an innovation within the NHS can often feel lonely and even soul-destroying at times. An email from a patient, a positive review, a story explaining the difference an innovation has made to someone’s life can replenish an innovator’s resilience.

Partners and mentors: The NIA’s success relies on its expert, well-connected and geographically spread supporters.

Our NIA mentors, who generously give their time in-kind, offer a vast breadth of expertise and experience and an enviable black book of contacts, helping Fellows to grow their skills and network of advocates.

Through the partnership with AHSNs, it is possible to connect Fellows with a broad range of technical experts (e.g. commercialisation, quality improvement, implementation science, large scale change) and an infrastructure that is deeply connected with its local health and care system. This provides opportunities to showcase innovation, to connect with local clinical experts, to identify trial sites and potential customers across the entire country.

Communications and branding: A well-known, credible brand attracts applicants, opens doors for Fellows and helps grow supporters.

When we launched the NIA, on its relatively small operating budget, we didn’t even have a website or a brochure. Our motto was: Deliver first and then you will have something of value to convey.

In the process of reviewing our first year, the resounding feedback from Fellows was to invest less in the bursaries for individual Fellows and more in central communications and marketing. Their ideal is for any NHS clinician, commissioner, manager or patient to know about and highly regard the NIA.

We now produce a quarterly INSIGHTS newsletter, marketing collateral (e.g. brochures), communication toolkits for all campaigns/activities, and have a rolling events calendar. With around 1.2 million NHS staff to reach, we are on a journey but are already seeing the benefit of the investment.

In summary, I’d say – as is so often the case – it is all about the people.

The Fellows we carefully select and support; the patients who drive our focus and keep us energised; the mentors, partners and supports who offer their expertise and networks; and the NHS staff we are trying to engage and excite by the huge potential of innovation.