About the programme
What are test beds?
Test bed sites are likely to be local groups of commissioners and providers, including NHS providers from all sectors: primary, community, acute and mental health. They will also have strong links to social care and to the local voluntary sector. Our Academic Health Science Network (AHSN) partners will identify and put forward these sites, making a case for why they offer the right conditions to test innovations. We will also explore larger potential test bed sites that may not be contiguous with AHSNs but may nevertheless offer advantages for example, town or city conurbations, or rural areas with specific needs.
Why are you doing this?
The NHS Five-Year Forward View highlighted how innovative ideas or technologies with the potential to improve patient care had failed in the past because they had been tried in isolation from other technologies, without changes to ways of working, or on top – not instead – of existing programmes. It therefore identified the need for ‘test bed’ areas with the willingness to adopt whole-system change, and the ability to measure benefit and pass on learning to other areas.
What type of innovations are you looking for?
We are looking for all types of innovation that can have a positive impact on healthcare outcomes at the same or reduced cost and help improve service delivery models across the NHS. We are interested in digital innovations that can help contribute to this, as well as innovations that have an Internet of Things focus. However, at this point we are welcoming innovations from any sector.
What problem are you trying to solve and what do you expect to achieve?
Test beds seek to address three important problems that have constrained the impact of innovation in the NHS:
- First, innovations are often implemented in isolation from each other—and from the infrastructure on which they depend.
- Second, there is a comparative lack of robust evidence about the effects of innovations in the real world, as opposed to experimental or research settings.
- Third, innovations are often introduced on top of existing working practices and infrastructure, some of which these new innovations may even be designed to replace. As a result innovations often simply add cost, with little or no gain in value.
There therefore remains a large, unexploited opportunity to combine different technologies, testing these together with innovations in how clinical services are delivered in real world settings. By evaluating combinatorial innovations carefully, we can identify those which produce significant health improvement at the same or less cost than existing practice. It is these high value innovations that the test bed programme seeks to promote.
How will it work?
This programme comprises four steps:
- A global call to innovators. At this stage, we are inviting interested organisations or consortia to provide an initial description of what they propose, how they propose to partner with test bed sites once they are selected, and what value they expect to achieve. In parallel, our AHSN partners will be working to identify appropriate sites.
- Shortlist and catalyse partnerships. The AHSNs will review the expressions of interest we receive from international innovators, and run a number of ‘matchmaking’ events over the summer which will provide the opportunity for the NHS to provide more detail on the problems or priorities they want help addressing.
- Proposals finalised. Following these events, potential test bed areas and innovators will have a period to solidify their joint proposals and finalise their partnerships. Where it is helpful, AHSNs may have a role in brokering these partnerships.
- Designation of test beds. Once agreements between innovators and NHS partners have been finalised, the programme will commence, with national support to solve problems and potentially financial assistance for local NHS organisations to cover the costs of implementation.
Who are the test beds likely to be?
A small number of test bed partnerships (around five) will be selected based on the potential value of the innovations and the commitments made by both innovators and NHS partners to test their package of innovations in real world settings.
Test bed sites will be characterised by strong clinical leadership, with an appetite for testing innovations, and have the infrastructure to support data sharing and a sufficiently large patient population to enable projects to be run at scale.
Innovations will need to demonstrate the prospect of improving health and healthcare outcomes at lower overall cost; in other words, high value innovations. The test bed programme is about deploying existing technologies in NHS settings—not about inventing new ones. Innovations should not be subject to further safety or regulatory tests and should
Making an expression of interest
Who can express interest in testing their innovations?
Expressions of interest are being invited from innovators from the UK and globally, working either alone or in a consortium. It is our intention to use the test bed programme to entrench England’s advantages as a destination of choice for health sector innovators seeking to demonstrate the value of new ways of delivering health and care services.
Innovators may come from any sector. NHS employees working alone or in partnership, medical technology, biotechnology and life sciences businesses voluntary and community sector organisations, academia and NHS bodies themselves are important sources of innovations.
How do I express interest?
Innovators will be required to fill out an expression of interest online. Information on how to do so will be available at www.england.nhs.uk/testbeds. Innovators have until 12 noon on Friday, 12 June 2015 to express an interest.
Event(s) for interested innovators to find out more about the programme will be held in May. We strongly encourage innovators to wait until after this event before submitting their proposals.
NHS and social care test bed sites
If you are an NHS or social care organisation interested in becoming a test bed site, you can attend a Q&A teleconference by registering here, further information about these events can be found here. Alternatively, please contact your AHSN or email firstname.lastname@example.org for further details.
Does it matter where innovators are based?
Innovators looking to participate in an ‘Internet of Things’ focused test bed must have a UK base. The ‘Internet of Things’ describes when everyday objects are connected to a network in order to share data and work together. There is no such condition for the other test bed projects.
How long will successful bidders be given to demonstrate their solutions?
The evaluation criteria against which the test beds will be measured will be agreed with both the test bed site and the innovator prior to the project commencing, as this will depend on the combinations of innovations being tested. The length of the evaluation will vary depending on the individual projects; however, this is expected to last around 2-3 years.
I am an international innovator – am I able to participate?
Yes. We welcome any innovator who thinks they have an innovation that can improve healthcare outcomes at the same or lower cost. We are, however, not able to provide funding to any innovator who does not have a UK base.
Do innovators have to be working in a consortium already?
No. Innovators can come forward as a consortium, but equally we are welcoming individual innovators who may find new innovator and NHS partners through the matchmaking process.
Expectations for successful candidates
What does the matchmaking process involve?
The matchmaking process aims to bring together innovators who can offer the greatest potential to improve health outcomes for equal or less cost with potential NHS sites with an interest in a similar area. The process will be flexible and iterative, focusing on catalysing new partnerships – or deepening existing relationships. The process is likely to include virtual opportunities to meet potential partners, as well as a number of face-to-face events around the country. We are designing the process in partnership with the AHSNs and programme sponsors. We envisage this phase running from July through to the autumn.
How will test beds be selected?
Test Beds will be selected by the end of 2015 following an assessment process in the autumn. We will invite final proposals from Test Bed partnerships in the autumn, with selection based on the strength of combinatorial innovation propositions and strength of partnerships between innovators and the NHS. We anticipate selecting around five or six Test Beds in December 2015, although if more proposals are of sufficiently high quality we may seek to back them as well.
How will Intellectual Property be protected throughout the programme?
Intellectual Property (IP) associated with existing technologies that are tested through the programme will remain with the developer. If new IP is created through the programme, its ownership will need to be determined locally on a case-by-case basis in discussion with the relevant Test Bed site. We do expect to share evaluation results widely, so all organisations must be prepared to share data and results from the evaluation.
I am already in a partnership – can we submit a bid?
Yes. Nothing precludes existing partnerships from submitting an expression of interest. However, we are naturally most interested in catalysing innovations that would not have happened anyway and are not interested in funding innovations that are already being funded from elsewhere. These need not be entirely new proposals, but could be proposals that seek to expand the scale or scope of planned or existing work that require rigorous evaluation.
We are already involved in another national programme (vanguard / Digital Participation Programme etc), can we still participate?
Yes. All health economies that meet the criteria set out in the prospectus are welcome to put themselves forward as a potential Test Bed site. However, the Test Bed programme provides an opportunity to evaluate combinations of innovations to identify those that produce significant health improvements at the same or lower cost. This programme is distinct from others that may be in play locally and any support associated with it must therefore be targeted at this programme’s objectives.
Is the Internet of Things a central requirement for all Test Beds?
The Internet of Things (IoT) is one potential application for Test Beds, but it is not the only focus. Test Beds should develop proposals based on innovations that have the highest potential impact on improving health outcomes at the same or lower cost. However, we will select at least one Test Bed that deploys an Internet of Things approach to achieve these objectives. In line with this, and the desire to scale any successful innovations more widely, we are also looking for all digital innovations to be developed with open standards for cyber security, privacy and interoperability.
What do you mean by ‘sufficient scale’?
Test Beds will need to include a large enough population group to provide sufficient data to support a robust evaluation. The exact population size required to enable this may vary by partnership, depending on the clinical area of interest and associated prevalence within the local population. We have indicated an overall population of 1m to demonstrate that we are seeking proposals of sufficient scale to move beyond initial pilots and provide robust evaluation, and that will consider scalability beyond initial testing. Sub-populations on which innovations may be focused – for example, people with long-term conditions – may of course be smaller than the overall population.
What happens once Test Bed projects are complete?
We anticipate that each Test Bed will need to run for 2-3 years to generate robust evaluations. National bodies, working with the AHSNs, Test Beds and others looking into adoption and diffusion, will explore how wider uptake of successful innovations can be encouraged. We are committed to using the flexibilities available to us to facilitate diffusion, which may include degrees of freedom in payment, tariff and information flows.
Will service users be involved in the test bed process?
We expect patients and the public to be engaged by innovators and potential NHS sites as they develop their combinations of innovations and consider how they best serve local patient needs. In recognition of this we anticipate including assessment criteria focused on patient and public engagement as part of the selection process.
Will there be any financial support accessible to the test beds?
NHS England will consider making available a limited amount of investment for each test bed to cover the start-up costs of NHS bodies supporting the implementation of test bed innovations. However, we expect innovators to invest as well; for example, to cover the costs of the new technologies themselves. It is important that the value proposition of innovations put forward for testing is strong enough to stand on its own merits rather than be continuously supported by government subsidy. Funding will be agreed at a later stage in the process, on a case-by-case basis.
How much funding is available for the programme and how will it be awarded?
The first wave of the programme has access to funding of £10m, which we expect to run for 2-3 years. However, it should be noted that this programme is not intended as a commissioning vehicle, but as enabler to unlock and test the potential value of innovations.
How will funding be allocated?
We will consider how funding should be allocated at a later stage in the process, as partnerships start to emerge. It is likely that funding will be allocated on a case-by-case basis. We are looking to back the best Test Bed proposals, with consideration for the strength of partnership and the potential value to patients and taxpayers alike.
Funding is primarily designed to support participating NHS bodies to ensure they have the capacity and capability to deliver their proposal. National sponsors will also fund the evaluation programme. We expect participating innovators and companies to invest their time, people and technology in return.
However, for the Internet of Things focused Test Bed or Test Beds some funding will be available to businesses, academia and public sector bodies to support collaborative projects which demonstrate the application of IoT technologies in real life settings. This is part of the Government’s integrated £40m programme to accelerate the development of the Internet of Things (IoTUK) over the next three years.
Is there seed funding to support people through the matchmaking process?
No. However, we will be providing advice and support throughout the matchmaking process to help the development of partnerships.
What funding is available for SMEs?
There may be some funding available for UK-based SMEs, which will be considered on a case-by-case basis. However, innovators should be prepared to invest their own time and technology.
What investment are innovators expected to provide?
We are asking innovators to contribute their innovation and associated capacity, capability and leadership to enable it to be effectively tested in a real world clinical setting. Recognising that some SMEs may not be able to invest at the scale required, some funding may be available to UK based SME organisations within designated Test Beds – the level of this funding would be agreed on a case-by-case basis.
What are the benefits for innovators, given there is little or no funding for them?
The test bed programme is providing innovators with a route to build partnerships with the NHS in order to test their innovations in real world clinical settings. In addition to access, the programme will provide central support that will focus on unblocking barriers to progress and any problems that arise through implementation. Where innovations prove to be successful, the programme will provide an evidence base for success within the NHS and national bodies and the NHS will look to support their further adoption and diffusion within the NHS in England.
What is the national approach to evaluation that will be used?
The national approach to evaluation is being developed and will be set out later in the process. However, it will build on a number of core principles:
- To have a clear understanding of the outcomes (health and wellbeing; care and quality; and efficiency) and impacts from each test bed, how these arose and whom they affected, and what costs and other resources were involved
- To give us early indications of change and effects as well as information on longer term impacts
- To be clear about the outcomes and how the inputs and activities contribute to these, through development of a logic model
- To have metrics to measure progress against the outcomes
- To have a control group for each Test Bed to establish what would have happened if there was no change.
As set out in the prospectus, the national bodies will cover the costs of developing the national evaluation approach and analysing and reporting on information collected nationally in order to establish the impact of the combinations of innovations. Sites will be expected to contribute to the development of the local approach, including definition of local metrics, and to collect and provide the necessary data. The costs for this will be managed by the local teams.
Where can I get more information?
You can find out more about the programme by contacting the Test Beds team via email@example.com