A presentation outlining Wessex AHSN's proposed approach to spreading and adopting best practice and innovation in health and care across the Wessex region. This presentation was delivered on 19 November at the AHSN's Innovation Forum, held in Chilworth.

1. A Methodology for Spread and
Adoption

3. What our stakeholders told us
Wessex AHSN
is above average or leading the field
• 78% recommend working with us
• 83% report a ‘good working relationship
– 11% higher than the AHSN average
• 66% say we have helped them achieve their objectives
– 10 % higher than the AHSN average
• 70% feel ‘involved in the AHSN’

4. What our stakeholders told us
Doing the right things, and doing them well
• ‘Priorities aligned to local priorities’ - 74%
• Effective at ‘focusing on the needs of patients and local populations’ - 71%
- 10% higher than AHSN average
• ‘Identification, adoption and spread of innovation’ - 65%
• ‘Confidence in the AHSN to deliver its plans and priorities’ - 66%
Working well together
• ‘Facilitating collaboration’ - 67%
• ‘Good accessibility’ - 75%
Building partnerships
• 42% have a good understanding of our role
- 70% feel clarity has increased in the last 12 months
• 35% have a good understanding of our plans and priorities
- only 1% have no understanding at all!

5. Where are we now?
The given
• The five licence requirements
• Patient Safety Collaboration
• Medicines optimisation (national
role); respiratory & nutrition
(national offer, our BRU and BRC)
• Vanguard support; Test Bed (if we
get accepted)
• Some aspects of our wealth
programme – Life Science Cluster,
genomics
Our choice
 Fewer things with greater impact
 Catalysing system change
 No more ‘seeds’, lots more spread
 Leapfrogging – moving much more
quickly from spot to spread

6. Why it’s important
• The stakes are high. The NHS needs to
transform the way it delivers care if it is to
meet the demographic and financial
challenges it faces.
• There is a good supply of innovations that can
help meet this challenge.
• But they aren’t spreading through the NHS at
anywhere near the rate that need to.

7. Aims of the methodology
• Use the evidence base on when and how good
ideas spread in healthcare.
• To develop a systematic approach to assessing
an innovations potential to spread and be
adopted.
• So that a decision can me made on whether
and how to support it to spread.
• And a consistent approach is used to develop
Spread Plans.

8. Overview of the methodology
Assessment Decision ImplementDevelop spread plan

9. Steps 1 and 2

10. Step 1: Potential to spread
There are 7 attributes known to determine the
likelihood that an innovation will spread.
1. It has a clear advantage.
2. The benefits are observable.
3. It is compatible with the needs of adopters.
4. How complex it is to adopt.
5. Adopters can trial it before committing.
6. Potential adopters can adapt it to their needs.
7. The strength and quality of the evidence.

11. Step 2: Will it be adopted?
Adopters are the individuals and organisations
that we want to implement the innovation.
It is important to be able to describe the
adopters as precisely as possible and to
understand the process of decision making and
adoption from their perspective.
Who are the
potential adopters?
How would they
benefit?
What could
constrain them?

12. Step 3

13. Step 3: AHSN decision
• What is the evidence that this innovation will
spread and be adopted?
• Build this in to our business planning process.
• A spread panel will take in-year decisions.
• New roles – Clinical Lead for Spread and
Spread Manager.

14. Step 3: Diffuse or disseminate?
Innovations can spread in 2 ways:
• Diffusion – communication through
horizontal/ peer social networks. Largely
unplanned and organic.
• Dissemination – a planned and active process
intended to increase the rate and level of
adoption. Use vertical/ formal networks.

15. Step 3: AHSN Support
A plan to diffuse

16. Step 4

17. Step 4: Diffusion
Innovations diffuse through horizontal
networks. They are were professionals meet,
share experiences, ideas and best practice –
where ‘word of mouth’ happens.
Examples:
• Clinical forums, such as Wessex Stroke Forum and
Wessex AHP Forum
• Training events – e.g for primary care or speciality
training for junior drs.
• Internet hubs

18. Step 4

19. Step 4: Dissemination
Innovations disseminate through vertical
networks. They are the formal networks that
bring together decision makers, set policies and
priorities and allocate resources.
Examples:
• The AHSN
• Local Medical Committees and Local Pharmaceutical
Committees
• The Strategic Clinical Networks
• The Hampshire Commissioning Network
• Wessex HEE and Research Networks

20. Step 4: Key roles in networks
Opinion leaders: Highly respected people who
influence others. Their opinions are sought and
valued.
Champions: Key individuals who are willing to
back an innovation and push for its adoption.
Networkers: Provide an important role
supporting the flow of information about
innovations across organisations.

21. Step 4: Network plan
• Identify the networks that can support the
spread of the innovation to the adopters
identified at step 2.
• Research how they work and how they can be
used to communicate and influence adopters.
• Identify the opinion leaders, champions and
networkers that can play a role in supporting
spread and adoption.

22. Step 5

23. Step 5: Communications plan
Brings together the advantages of the
innovation, our understanding of the needs of
potential adopters and our intelligence on the
key networks and key people.
Priority audiences Key messages Communication
actions and channels
Specific organisations,
departments, roles and
people. Provider and
Commissioner.
Messages that are specific
to each audience.
Responding to the benefits
and constraints at step 2.
Using the intelligence on
key networks and key
people at step 4.

24. Step 6

25. Step 6:Implementation and
sustainability plan
Organisation commitment
Executive support, time and cost, other departments, reporting
arrangements …
✔
System commitment
Commissioner support, networks interested, communications,
reporting …
✔
Implementation team
Executive sponsor, clinical lead, project manager… with sufficient time. ✔
Support for implementation
AHSN, the innovator, champions, other adopters, specific skills such as
commissioning/ informatics
✔
Sustainability
Adopters continue to network with other adopters and receive and
share information on its impact
✔
A checklist covering the main factors that determine the success of the implementation
of an innovation and its sustainability:

26. Groupwork

27. Groupwork
4 innovation stations:
1. OPEN (Older People’s Essential Nutrition)
2. MISSION Severe Asthma
3. Mental Health (psychosis) Quality Improvement
4. Dementia Friendly Practices
Road test the templates
Capture your learning, feedback and improvements
on the methodology on the flipchart

28. Groupwork
Two tasks:
1. Road test the methodology and templates
2. Capture your learning, feedback and ideas for
improvement on the methodology on the
flipchart.
Identify your top 2 points to feedback in plenary.