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Time for the NHS to embrace Expo-nential Innovation – Dr Mahiben Maruthappu

The Senior Fellow to NHS England’s Chief Executive reveals how Expo 2015 will see the publication of an overview of NHS England’s innovation achievements to date:

In 1965 Gordon Moore, co-founder of Intel, made an observation that the number of transistors in an integrated circuit would increase exponentially; doubling every 18 months.

Moore’s law has since set the pace for the electronics industry, from processing power to the size and cost of computers, to the number of pixels in digital cameras – innovation has accelerated exponentially.

This trend has disrupted almost every part of our world, from smart-watches, to sensors, 3D printers, smartphones, apps and online platforms; analogue has become digital at an unparalleled rate.

Industries based on these technologies have understandably seen similar rates of change. A paper ticket was once a critical ‘trusted’ travel document, yet today around 95 per cent of tickets are issued digitally as e-tickets. A decade ago visiting banks was the norm; in Britain we now use our mobile phones to make 18.6 million banking transactions every week.

So, what about healthcare?

As many already know , The NHS has unprecedented pressures; a growing, ageing population with more long term conditions; more expansive, expensive treatments; and significant efficiency challenges. But opportunities of the digital age and exponential innovations, allow us to make significant strides towards better patient-care, more accessible patient services, faster operational efficiencies and more uniform quality. The time is right and the time is now.

We have seen glimpses of innovation agility across the system – last year just three per cent of GPs in England offered patients’ online appointments, repeat prescriptions and access to summary information in medical records. Now this stands at 97%. A decade ago, it cost millions to sequence a genome, now it’s less than £1,000.

The challenge is we have an innovation gap.

In any complex organisation with a large and diversified workforce, 1.3 million in our case, innovations in process, culture and human performance struggle to qualify as exponential; instead, recent history has revealed a preference for the incremental. It is this difference between exponential and incremental change that presents a gap, an innovation gap, that must be filled if we are to unlock our health system’s potential.

First, we need more organisational innovation- where pan-NHS WiFi, digital medical records and new service models allow staff to better innovate. Where people are geared to embrace rather than resist change. 37 sites have been launched across the country – our Vanguards – where care will be better integrated, and barriers dissolved between health and social, primary and specialist care. These locations will serve as hot spots for new ways of working, serving over 5 million people, providing an opportunity for the organisational innovation the NHS deeply needs.

Second, innovations need to be combined. The service is on the cusp of an innovation revolution, with radical changes in genomics and personalised medicine; data and digital; hardware and wearables. Combining these genres in novel ways will fundamentally transform our health system, amplifying the impact these technologies would have otherwise had in isolation. Linking medical records to genomic sequencing and smartwatch data will unlock deeper insights about patient wellbeing than any one of these alone. A handful of NHS ‘Test Bed‘ sites are being developed across the country to deliver this, locations with over 1 million citizens that combine innovations in new and different ways.

Third, scale must underpin all we do. Google, a company with over one billion users, understand how to build technology at scale, and the culture to support it. All Google programs build scale into their design; developers are asked to consider how products will expand to hundreds of millions of people, and leverage other parallel projects.

Third, we need scale. Google, a company with over one billion users, understands how to develop technology at scale, and the culture to support it. All Google programs build scale into their design; developers are asked to consider how products will expand to hundreds of millions of people, and leverage other platforms.  The NHS, which has around 1 million patient contacts a day, must always factor-in scale. Without it, an exponential innovation in healthcare cannot have impact. We launched the NHS Innovation Accelerator (NIA) in January to explore the system-wide barriers and enablers to scale, working alongside innovators and entrepreneurs to build an ecosystem that accelerates NHS adoption and change.

Cutting across each of these, the system will need to become more agile, about design, testing, adoption and roll-out. It will need to deliver.

The NHS, which has around one million patient contacts a day, must always factor-in scale. Without scale, an exponential innovation in healthcare can have no impact. We launched the NHS Innovation Accelerator (NIA) in July of this year, to explore the system-wide barriers and enablers to scale, working alongside innovators and entrepreneurs to build an ecosystem that accelerates NHS adoption and change.

At the core of each of these strategies is delivery. We need to learn how to be more agile about design, testing, adoption and roll-out. While the stakes are high and ambitions are clear, delivery is key.

Next week at NHS Expo, our principal event of the year, we will be publishing an overview of NHS England’s innovation achievements to date, from digital to genomics, diabetes to models of care, helping our partners to explore the landscape of future opportunity, to build a bolder, braver, technology-fluent NHS.

With over 5,000 people attending and 100 workshops, Expo will provide a unique forum to discuss and determine how the NHS will embrace Expo-nential Innovations, and set forth its future.


Image of Dr Mahiben MaruthappuDr Mahiben Maruthappu is a London-based doctor and Senior Fellow to the Chief Executive of NHS England, focusing on national policy and strategy.

He co-founded the NHS Innovation Accelerator (NIA), and was recently the first person from British healthcare to be included in Forbes’ 30 under 30.

He has advised a range of organisations, from start-ups to multilaterals, including the Swiss government, the Experiment Fund and the World Health Organisation.

Mahiben has a strong interest in research with over 60 peer-reviewed publications and 50 academic awards. His work has been featured by BBC News and international press.

He is Chairman of the UK Medical Students’ Association (UKMSA), and has authored three medical books. He was educated at Oxford, Cambridge and Harvard universities.

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