Examples of barriers against types of innovation
| Regulatory | Structural | Cultural | Operational | |
|---|---|---|---|---|
| Emergent innovation | No clear regulatory pathway into the market for digital innovations (eg, what evidence is required) | Innovation grant schemes such as SBRI lack committed forward procurement to convert research into contracts | NIHR funding bias towards academic achievement at the expense of frontline or commercial impact | Principal investigators are generally not successful entrepreneurs; innovation itself is not easy to implement or use |
| Required innovation | NICE focus on cost effectiveness as opposed to cost benefits (eg, switching costs for CCG) | Costs of innovation cannot be offset by later or distant benefits. | Lack of accountability and transparency for variation in uptake (eg, through patient pull) | API of primary care systems generally not available impeding integration of best practice applications to support clinical decision making |
| Optional innovation | No clear regulatory pathway into the market for digital innovations (eg, what evidence is required) | Procurement focused on cost rather than value and separated from clinical need | Separation of day-job (urgent) and innovation agenda (important) in most provider and commissioning organisations | Lack of capacity and skills to systematically define problems and scout for solutions |
API, application programming interface; CCG, Clinical Commissioning Group; NICE, National Institute for Health and Care Excellence; NIHR, National Institute for Health Research; SBRI, Small Business Research Initiative.