Shared risk / shared reward: key to clinical innovation between private and public sectors?

Innov“Emperor’s New Clothes or the Way Forward? The Opportunities & Challenges of Clinical Innovation”. This was 2015’s teaser title for the Cardiff University Innovation Network event, held at the Heath Hospital in Cardiff.

While my professional links with clinical healthcare are limited, I continue to find the subject area compelling. In Wales it’s a perennial political football. Part of my problem in observing and digesting these events might be that I’m hankering for some BBC Question Time style debate, which is never likely to happen.

2013 – Innovation in healthcare
2014 – Dying to talk – an event on Healthcare In Wales

Having attended the previous two related events in 2013 and 2014, my trilogy would be completed with one more trip to north Cardiff, so I went see if this one would unearth anything new for the medical layman.

Each of the four speakers were experienced professionals with relevant – if naturally quite specific subject matter.

Abigail Harris
Jared Torkington
Graham Ewart
Professor Ian Weeks

The man from the private sector stood out. Graham Ewart appeared to be a highly successful businessman based in south Wales; a tall, pragmatic straight-backed Scot who appeared to talk sense from outside the immediate clinical space.

Ewart advocated transparency, league tables and performance related payments as a way forward for clinical innovation. He claimed that the NHS is not set-up for a culture of innovation and, citing a PriceWaterHouseCoopers report, said that it’s accepted that not many in the space are good at innovation.

His other ideas included the adoption of a Venture Capital approach to innovation, and a need to think of the patient as a consumer. Ideas you might think of as refreshing or frightening, resonating with the potential vocabulary of a privatised NHS.

clinical-innovation-wales

Deputy Health Minister for Wales Vaughan Gething (far left) is shown the latest life-saving equipment used by Wales Air Ambulance at the Ministry of Defence’s Caerwent training facility in Monmouthshire.
Picture by Mark Hawkins / Composed Images for Wales Air Ambulance.

[Wales Air Ambulance Medics Complete Training]

Shared Risk / Shared Reward

Bubbling up from the event for me was one key idea: ‘shared risk / shared reward’. In a final Q&A session with all speakers, this was presented as a known thing, perhaps a thing people in the space frequently spoke or wrote about. But it was new to me. It was also reworked as ‘outcomes reward’ by the Head of Innovation at the NHS, an audience member.

The suggestion is that both private and public sector bodies might share the risk and the reward of an innovation, whatever it be. (And it often struck me that innovation equated to a new piece of hardware, a clever tool or piece of equipment, rather more than a system or broader way of working).

Would that shared responsibility be more likely to encourage innovation? It sounded interesting. If legally and politically workable, might it be an answer to more effective collaboration? There would clearly be a great many legal hurdles, but it was a start. When asked if they would enter into a long term relationship with the NHS based on shared risk / shared reward, I believe each member of the panel quickly replied yes.

This year the event seemed significantly down in numbers of attendees, with a slimmed down buffet to boot. Is appetite for the subject on the wane, or could the format do with a reboot?

Either way, it will probably run again next year. And you might even suggest that this itself reflects an issue with innovation in the public sector. Many things tend to simply run and run, indefinitely, in oblivious cycles, meaning that innovation requires an uncomfortably disruptive force.

Here’s a Cardiff University curated Storify event commentary, with thoughts from other attendees. Please tweet @mawkins if you’d like to comment on this post.

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