Adopting Innovation across an NHS Ecosystem in the East of England- a realist evaluation

Background: Innovation is critical to transforming how health services can be delivered more effectively, efficiently, and with better outcomes. In 2021, the Health Foundation launched the Adopting Innovation Programme to help stakeholders within the NHS become better adopters of innovation. The Cambridge and Peterborough Adopting Innovation Hub (CPAIH) was one of four ‘innovation hubs’ funded to act as centres of expertise and provide innovation support for organisations and their local health systems. This study describes the findings from the local evaluation of the CPAIH. Methods: A realist evaluation with a multi-method study design was conducted via three primary data sources: documentary review, thematic analysis of formative evaluation reports and data sets, and interviews with stakeholders. Using thematic analysis and realist logic of enquiry context-mechanism-outcome configurations (CMOCs) were identified. Results: The evaluation identified 6 emergent CMOCs to inform a programme theory of what works and outlined CPAIH’s principles on embedding innovation in the regional healthcare system. The themes identified from the results included: the need to establish infrastructure and mechanisms, implement system innovation governance processes, exercise strategic leadership, foster effective communication, facilitate citizen co-production, and sustainably build an innovation pipeline to streamline and standardise decision-making. Conclusions: The evaluation demonstrated that by creating a robust, collaborative, and adaptable ecosystem, the CPAIH has laid the groundwork for sustained innovation in healthcare in the East of England evidenced through its absorption into the Integrated Care System to address health inequalities faster. Through a combination of dedicated roles, shared resources, citizen involvement, and systematic decision-making processes, traditional barriers to innovation were overcome whilst creating a culture that values continuous improvement and responsiveness to patient needs. The CPAIH’s approach could serve as a model for future innovation systems.