North West Coast AHSN Steering Group · This short paper makes proposals to be considered by the...

North West Coast AHSN Steering Group

AGENDA Monday 22 October 2012, 1.00pm – 3.00pm

The Walton Centre, Liverpool

1. Welcome and Introductions

2. Apologies for absence 3. Notes of meeting held on 8th October 2012

4. Matters Arising from the notes

i. Feedback on NWC Prospectus/application process (if received) ii. Programme Management – Confirm Arrangements iii. Membership Fee – Agree Principles iv. Chair and Managing Director – Job Description and Person Specification –

Finalise v. Transition Project Plan (Agenda item 6i) vi. (Re) Establishment of Sub Groups and Feedback (agenda item 6ii) vii. Interview Preparation (agenda item 6iii) viii. Dates of Future Meetings

5. Feedback from Stakeholder Event, 12 October, 2012

6. Substantive Items for Discussion

6i Transition Project Plan

6ii. Sub Groups – Feedback 6iii Interview Preparation

7. Time, date and location of meetings to end of March 2013

NB Due to the short timetable, a number of items will be circulated before the meeting or tabled

Notes of the meeting of 8th October 2012


Present Kathy Doran (KD) – Chief Executive, NHS Cheshire, Warrington and Wirral Dr Lynne Goodacre (LG) – Project Manager Dr Mike Morris (MM) - Associate Director of Research, Development and Innovation, The Walton Centre NHS Foundation Trust Prof Heather Tierney-Moore (HTM) – Chief Executive, Lancashire Care NHS Foundation Trust Prof Ian Greer (IGr) - Executive Pro-Vice Chancellor, University of Liverpool Raj Jain (RJ) – Chief Executive, Liverpool Heart and Chest Hospital NHS Foundation Trust Stuart Eglin (SE) - Director of Research & Development, NHS North West Karen Partington(KP) - Chief Executive, Lancashire Teaching Hospitals NHS Foundation Trust Prof Tony Gatrell (TG) – Dean Faculty of Health and Medicine Lancaster University Chris Linward – (CL) – AquA Prof John Goodacre (JG) – Cumbria and Lancashire CLRN Clinical Director Prof Ken Wilson (KW) - Cheshire and Merseyside CLRN Clinical Director Apologies Prof Sir Ian Gilmore (IGi) – University of Liverpool Kathy Thomson (KT) – Chief Executive, Liverpool Women’s NHS Foundation Trust Dr Liz Mear (LM) - Chief Executive, The Walton Centre NHS Foundation Trust Roz Way (RW) - Director of Operations, Liverpool Health Partners Tracy Bullock (TG) – Chief Executive, Mid Cheshire Hospitals NHS Foundation Trust In Attendance Caroline Welton – Administrator, Lancashire Care NHS Foundation Trust (Minutes) 1. Welcome and Introductions Heather Tierney-Moore opened the meeting by welcoming everyone. 2. Notes of previous meeting The notes of the previous meeting were accepted as a true record.

3. Matters Arising There were no matters arising. Heather Tierney-Moore advised the group that the bid had been successfully submitted. There has been no response to date. The name that was decided on was North West Coast. HTM confirmed that has been one unfortunate inaccuracy relating to lack of academic strength in Stroke, which was clearly not the case.

4. Programme Management Heather Tierney-Moore felt that it was important to move forward with the complexity of the transition. HTM also advised some additional resource was required until the Chair and Managing Director roles have been filled. KD has written to Local Area Team Directors within Cheshire, Merseyside and Warrington regarding contributing £50k. KD confirmed that they had all agreed. HTM advised the group that she was checking with the HIEC regarding a contribution from Cumbria and Lancashire as they had an under spend. This would also help the transition of the HIEC into the AHSN. KD confirmed that Phil Dylak from AQuA is willing to offer some programme management support to the group for two days a week. 5. Membership Fee A discussion took place regarding the membership fee. 6. Chair and MD Recruitment The job description and person specification for the Chair role was circulated. A discussion took place regarding the job description. Lynne Goodacre advised if anyone has any changes they would like to make to the Chair job description to forward to her by Friday. HTM advised that if anyone has any names that would be suitable for the role to discuss with HTM or Kathy Doran. HTM or KD will have conversations with those people. It was decided that the Chair would be in shadow form until the Network has the licence. HTM recommended doing the same for the MD role. ACTION: LG to amend the Chair job description and circulate. 7. Making Prospectus “Live” HTM confirmed that she had recently had a discussion with Jonathan Pearson from Finnamore about next steps. HTM feels that the group need to keep going as the worst case scenario is that the bid would be delayed until the second round. There is only a month before the interview. Issues to be addressed include:

Legal form of the AHSN

Clear relationships defined between partners and members

Models of delivery

Supply chain

Nature of the contract with AQuA and other

Detail of the business plan Lynne Goodacre raised the issue regarding the continuation of the Work Streams Sub Groups. A discussion took place regarding the work streams and it was decided to continue the subgroups to develop the detail. Service Improvement – Raj Jain Industry – Prof John Goodacre Informatics – Mike Morris Personalised Medicine – broadly completed PPI – Lynne Goodacre Education – Lynne Goodacre Research – Stuart Eglin

8. AQuA

A document was circulated regarding an event AQuA are organising called Innovation: accelerating adoption and diffusion to improve health and healthcare at York Race Course in October. HTM advised that there had been an invite from NHS Confederation for a Study Visit for AHSN’s to South Denmark in December. It was decided that the group should book two places and confirm names in due course. ACTION: HTM office to circulate the invite from NHS Confederation to the Steering Group. 9. Interview Preparation Kathy Doran confirmed that together with HTM, they had decided provisionally to suggest John Goodacre, Ian Greer and Ken Wilson to become involved in the interview process. Mike Morris confirmed that Liz Mear is happy to be involved in the interview. A discussion took place around this process. Ken Wilson suggested that representatives who could discuss industry and innovation should be considered and that it may be worth considering a reserve team. Raj Jain felt that the interview process will be similar to the Monitor Process. RJ explained the Monitor process. It was suggested that David Fillingham (AQuA) could be involved in the interview process. Chris Linward confirmed that there are 25 people assessing each bid. Tony Gatrell offered to conduct a mock interview for the panel. It was also mentioned that Sir David Nicholson is required to show progress to the Prime Minister in December 2012. 10. Future meetings The group decided to hold steering group meetings on a monthly basis alternating between Liverpool and Preston. ACTION: HTM office to organise monthly meetings. 11. Any other business There was no other business. Date and time of next meeting Monday 22 October 2012, 1.00pm – 3.00pm, The Walton Centre, Liverpool

AGENDA ITEM 4 iii

1

North West Coast Academic Health Science Network and AQuA: proposed joint

working arrangements

1. Introduction

The proposed North West Coast Academic Health Science Network has produced a

detailed prospectus and is currently developing its business plan. This allows for a

better alignment of those organisations already working on innovation and improvement

across the AHSN. It will provide stronger links between technology adoption and

service improvement, and bring tangible benefits to patients and to citizens. The

prospectus has been completed to an extremely tight timescale. As a result of this

there are a number of practical questions which now need to be resolved ahead of the

expected meeting with the National Interview Panel in November.

This short paper makes proposals to be considered by the NWC AHSN’s NHS

membership. It addresses how improvement capacity can best be secured for the

various AHSN work streams; how AQuA’s existing work with its members can be built

upon; and critically how a workable model for membership subscriptions can be

developed. Feedback from NHS organisations suggests that it is desirable to avoid an

additional fee for the AHSN over and above the AQuA fee and this paper proposes a

means of achieving that.

2. The NWC AHSN and Improvement Capacity

The AHSN’s overarching aims are to deliver improved health and wealth for its

population. It will achieve this by aligning the efforts of its members onto a few big

priorities. It will work with and through a number of existing assets within the AHSN’s

area.

AQuA is identified in the prospectus as an important asset in terms of service

improvement and the spread and adoption of best practice. In this role AQuA will work

in close co-operation with other assets such as TrusTech and North West Leadership

Academy.

3. AQuA’s Work Programme and the NWC Academic Health Science Network

In discussion with its members, AQuA has configured its current work programme in

line with the NHS Outcomes Framework. AQuA’s work programme falls into three

categories in relation to the NWC AHSN’s proposals:

I. Areas of direct overlap - there are some AQuA’s work streams which align

directly with the intent set out in the AHSN prospectus, for example, the drive to

develop improvement capability and the AQuA Academy; links to AQuA’s work

on long term conditions, patient experience and patient safety

AGENDA ITEM 4 iii

2

II. There are some new areas proposed in the NWC AHSN prospectus to which

AQuA could contribute, e.g. developing a model for the adoption and spread of

High Impact Innovations and NICE guidance; extending the use of the AQ

approach to deliver consistent, reliable care; embedding the use of telemedicine

and other digital solutions within AQuA’s long term conditions and service

redesign portfolio.

III. There are some areas which are not covered the NWC AHSN prospectus but

which AQuA will continue to pursue as they are highly valued by its membership.

For example, AQuA’s work on integration, on hospital mortality and on shared

decision making.

It is also important to note that AQuA covers the whole of the North West and so will

already be working closely with many of the partners within the proposed NWC AHSN.

4. AQuA Membership Subscriptions and AHSN’s Membership Subscriptions

The NWC AHSN’s prospectus does not currently propose a membership fee. However,

it is understood that the NHS Commissioning Board expects partner organisations to

make a financial contribution to their AHSN. The aim is to demonstrate to the NHS

Commissioning Board the commitment of the NHS to invest in the AHSN in order to

secure the proposed £10m of devolved funding. AQuA currently charges its members

an annual fee of £40000.

The risk of proposing a separate AHSN membership fee is that NHS organisations may

be reluctant to pay a further sum over and above the AQuA fee. This is a risk that

should be avoidable given that £10m is available to be drawn down from the NHS

Commissioning Board if the AHSN licence is secured.

A pragmatic solution to this is that a single £40000 fee is charged to cover both AQuA

and the AHSN. Approximately £20000 of this would be for AQuA activities that are not

part of AHSN’s priorities and would come directly to AQuA; £20000 would go to the

AHSN. (The precise split will need to be determined through more detailed planning and

agreement in the coming months.) The AHSN, from its overall income, will then

contract with AQuA to the value of this additional £20000 per annum for the five year

period of its operating licence. AQuA will align half of its work programme with the

AHSN’s priorities in return for this income stream. There may also be opportunities for

AQuA to earn additional income beyond this to support other aspects of the AHSN’s

work as it develops.

This approach to membership income would be a “triple win”. The AHSN can

demonstrate investment from the NHS into the AHSN; the NHS members who are

already AQuA members will not need to pay more than the existing £40000 per annum,

AGENDA ITEM 4 iii

3

and for this they will get both AQuA and the AHSN; AQuA will be able to retain its

membership model (which has been strongly supported) whilst also aligning its work

with the AHSN’s priorities.

It should be noted that the AQ Programme is not funded from the AQuA membership

fee but is commissioned separately by PCTs (and in the future by CCGs).

5. Account Management System

AQuA has a well developed relationship management model with its members. This

includes assigning Account Directors and Account Managers to each member, who

make visits at least bi-annually. A suite of communication methods including a

members’ Web Portal are in place. Benefit to members is captured on a customer

relationship database.

The opportunity exists to explore AQuA being contracted to provide the account

management role for the NWC AHSN NHS members. This would avoid multiple

contacts with NHS organisations and help increase alignment between NHS service

improvement priorities and the wider aims of the AHSN.

6. Use of AQuA’s Non Recurrent Reserves

AQuA is fortunate in having been provided with “legacy” funding by NHS North West to

be invested strategically in improvement initiatives. The AQuA Board and its AGM

approved the use of these reserves in 2013/14 on a small number of big priorities.

These investments could be used in part to pump prime the AHSN’s improvement

activities. For example:

I. Improvement capability - the AQuA Academy intends making a significant

investment in improvement capacity across its membership in 2013/14. For

example, a goal might be to develop at least one advanced level improvement

expert in each NHS organisation, as well as strengthening the improvement skills

of frontline staff and the leadership role of boards.

II. Developing an approach to the more rapid adoption of High Impact Innovations –

AQuA could utilise its non-recurrent reserves to develop large scale change

approaches and to utilise the AQ methodology to support the much more rapid

implementation of High Impact Innovations, iTAPP technologies and NICE

guidance.

Subject to approval by the AQuA Board, AQuA could contribute substantial funds to

these activities which would strengthen NWC AHSN’s proposals and allow us to

accelerate progress in year 1. Clearly it would be an advantage for the NWC AHSN to

be able to describe this at interview with the NHS Commissioning Board.

AGENDA ITEM 4 iii

4

(Other proposed uses of AQuA’s reserves will be further investment in its Integration

Programmes and in supporting its members responses to “Francis II”.)

7. AQuA’s Position within the NWC AHSN Governance Arrangements

AQuA is a provider, not a payor, and it is not appropriate for it to be a full member of the

NWC AHSN Board. It is however very likely that the NWC AHSN will maintain an

advisory and supportive structure to the Board, and the AQuA CEO could be a member

of such a structure. In this role the AQuA CEO could also be co-opted onto the NWC

AHSN Board as a non-voting member to provide expert input in relation to service

improvement.

8. Conclusion

The NWC AHSN has produced a detailed prospectus and is currently developing its

business plan. The proposals in this paper are aimed at resolving a number of practical

issues in relation to the alignment between the AHSN and AQuA. They provide added

strength to the case which can be made to the NHS Commissioning Board at interview

in November.

The views of the NWC AHSN’s NHS members are therefore sought on these proposals.

David Fillingham

CEO

AQuA

October 2012

1


Monday 22 October 2012

Agenda Item 5 – Feedback from Stakeholder Event

PURPOSE

To apprise the Steering Group of the Stakeholder Event, 12 October, 2012. DISCUSSION The event was chaired by Professor Tierney – Moore, and attended by a wide range of stakeholders, including chief executives, senior clinicians, R&D professionals and managers. The event provided an opportunity to consider what the AHSN will do, and the factors that will drive this. Discussions at the event therefore covered both practical matters and more fundamental philosophical questions. The purpose of the event was four fold:-

• To review progress to date • To identify further work needed • To agree how this work will be delivered • To make decisions

To address these points, two sets of guided group discussions took place. The first group discussion was concerned with themes, aims and priorities (What will the AHSN do? What will its operating model be?) and goals, targets and outcomes (How will we know if the AHSN is working – what are its “deliverables?”). The second group discussion was about structure, governance and membership (How will the AHSN be organised and run? How will members contribute?) and the Business Plan (Who does what next)?. Discussions were wide ranging and enthusiastic. Some of the main issues and points raised are listed in the annex to this paper. At this stage there is still uncertainty about a number of aspects of the AHSN. The relevance of all of the material produced on the day to the AHSN business plan and operating model, and in planning future stakeholder and engagement events will be carefully considered.

2

RECOMMENDATION The AHSN Steering Group is asked to note and discuss the feedback from the stakeholder event, consider what further stakeholder events are needed, and what their form and content should be. Philip Dylak AQuA Research Associate 17 October, 2012.

3

Annex Main issues and Points Arising From AHSN Stakeholder Event, 12 October 2012

1. Themes, aims and priorities - What will the AHSN do? What will its operating model be? Goals, targets and outcomes - How will we know if the AHSN is working – what are its “deliverables?”

Concern that core function is not clearly stated. The core purpose is about innovation and its diffusion across the NHS. Should be more about “H” and “N” and less about “A” and “S”.

There should be a cadre of generic innovation officers who would work in parallel to the research support officers funded by CLRNs – this would accelerate and streamline adoption and diffusion, and represent a tangible commitment to service improvement.

We can turn the target argument on its head – rather than asking what targets the AHSN should adopt, we could ask how the AHSN can help its partner organisations to achieve their existing targets

Cardiac and stroke should be merged into one cardiovascular disease priority, as this better describes the health challenge facing the region covered by the AHSN.

Should implementation of NICE guidelines be a priority for the AHSN, when this is already a “given” ? NICE Guidance is evidence which has already been appraised and now needs to be put into practice – whether or not through the AHSN. Should the priority actually be to address the challenge to change cultural behaviours to ensure delivery and implementation of NICE guidance in practice and achieve the other objectives of the AHSN? Should this be one of the seven themes?

There needs to be a link to public health and local authorities – the AHSNs should be concerned with making large scale change across populations. Public health intelligence will help the AHSN to know whether the change has been successful.

The AHSN needs to support the commissioning function, not just the providing function, and work with clinical networks on the definition of working standards

The Prospectus contains metrics which are about process. The AHSN will need to measure success in terms of outcomes – e.g. QALYs, health gain.

Developing partnerships with industry may help where there are mutual benefits – but do we also need a code of practice or ethics so that we do not collaborate with inappropriate organisations? Need to ensure effective and appropriate governance models so that the NHS and industry work in synergy.

4

Think outside of Meditech and Pharma industries, and about processes, not just products – Tesco are the industrial partners for Whizz Kidz/Child in a Chair in a Day, and have been very effective. The supply chain/just in time approach they used to speed up delivery could be replicated elsewhere.

Involvement of the LEP (Local Enterprise Partnership) is essential

Duplication of effort is evident across the AHSN area and could be improved.

Another key concern should be to streamline and simplify processes across the pipeline – we should not be afraid to devolve discrete pieces of work to small, effective groups who would deliver on behalf of the whole.

Population health perspective - is it more useful to focus on this, rather than national priorities ?

Prospectus is too busy and prescriptive – the key vision needs to be simpler, with a “strap line” to focus delivery of AHSN. The business plan needs to be shorter, more focused and less repetitive than the Prospectus currently is.

The description of the themes and core functions could be improved – the various elements of the Prospectus could be better aligned.

We need to learn from the HIECs, which had similar tasks and objectives to the AHSN – but it took them a long time to make changes – why?

Maternity and child health should be a “pathfinder” theme – there are currently over 30 active projects in this area covering the whole pipeline – their implementation/development could be accelerated within the AHSN – there is a need for some quick wins to win over the cynics and skeptics

The AHSN needs a website to help to establish the AHSN’s identity. It should be about the AHSN and what it does – it should not try to be an expert resource – it should direct users to looking for specialised information to proven websites

The AHSN has to encourage wide and fast diffusion and spread – but it also needs “blue skies” thinking and to incorporate the breakthrough approach to encourage and reward high flyers.

2. Structure, governance and membership (How will the AHSN be organised and

run? How will members contribute?) The Business Plan (Who does what next)?.

The AHSN does not feel joined up as yet – there remains a lack of clarity across the AHSN region about what is being developed in academia and how this could be addressed for clinicians. A key purpose of the AHSN would be to close this loop and add value in this area.

5

The AHSN’s role is complimentary to but distinct from CRNs.

Strong clear clinical leadership is needed

Workforce implications not are clear - what will organisations be asked to commit to, and are there training and education implications?

Not yet enough engagement with all partners and with all service users – so the “bottom - up pull” which should drive the AHSN has not yet been created.

Bringing together different and disparate partners is a major challenge – the culture needs to be in place to support delivery. Culture change is needed – but can you measure it and recognise when you have it? Likewise – how does one measure improved collaboration when innovation and improvement often take place in silos?

What networks are in place already, and how do we, as an AHSN network bring them things together? Would a “strap line” or over arching theme help to bring all this together?

What is the role of the CQUIN mechanism – it provides the potential to link finances and outcomes/compliance/involvement - will it play a role?

Need to be clearer about how the AHSN manages non - compliance or under performance – the governance principles of 'being a good partner' should apply – the AHSN’s role should be supportive and developmental, not punitive – “all carrot, no stick”

Other levers for change include reputation/kudos, providing targeted resources and support, education and training, and profit sharing. Communities of practice are seen as a means of developing and reinforcing innovation in practice.

AHSN should not increase administration, documentation or data collection requirements for its partners, unless it can exceptionally be justified in the interests of patients, staff or organisations. If it has a performance management role it should align with existing approaches – not duplicate them or create new workloads.

Need a strong upstream link with education and training – get things right at source rather than correcting them later on.

Funding model needs clarity – NHS organisations have to make a tangible financial contribution to their AHSN in order to demonstrate commitment. “In kind” contributions (e.g. staff time) or contributions from other sectors (e.g. industry, E.U.) are unlikely to count, but new income could offset the costs of contributing. This would make a top slicing model more palatable.

6

The collective strength of the AHSN should equip it to attract EU funding. There is potentially huge spend to save capacity, and opportunities to generate new income from this and other sources. From a financial point of view, the biggest gains are probably to be made from aligning academic and industrial interests

A means of aligning funding flows across the network needs to be found

Need to clarify profit sharing arrangements – do financial gains accrue to the whole AHSN, to the organisation driving the change, or are they distributed according to some other principle?

Need to consider how the AHSN will deal with non - public sector organisations which join the AHSN in terms of both financial contribution and administrative arrangements and whether Memoranda of Understanding will be needed for an partners or members.

Developing Intellectual Property mechanisms across the AHSN is important.

1

Feedback from the Stakeholder Event held on 12 October, 2012. The event was chaired by Professor Tierney – Moore, and led by Philip Dylak, AQuA Research Associate who is working on the transition of the AHSN. It was attended by a wide range of stakeholders, including chief executives, senior clinicians, R&D professionals and managers. The event provided an opportunity to consider what the AHSN will do, and the factors that will drive this. Discussions at the event therefore covered both practical matters and more fundamental philosophical questions. The purpose of the event was four fold:-

• To review progress to date • To identify further work needed • To agree how this work will be delivered • To make decisions

To address these points, two sets of guided group discussions took place. The first group discussion was concerned with themes, aims and priorities (What will the AHSN do? What will its operating model be?) and goals, targets and outcomes (How will we know if the AHSN is working – what are its “deliverables?”). The second group discussion was about structure, governance and membership (How will the AHSN be organised and run? How will members contribute?) and the Business Plan (Who does what next)?. Discussions were wide ranging and enthusiastic. Some of the main issues and points raised are listed in the annex to this paper. At this stage there is still uncertainty about a number of aspects of the AHSN. All of the material produced on the day will be presented to the AHSN Steering Group and its relevance to the AHSN business plan and operating model, and future stakeholder and engagement events will be carefully considered. Philip Dylak AQuA Research Associate 17 October, 2012.

2

Annex Main issues and Points Arising From AHSN Stakeholder Event, 12 October 2012

1. Themes, aims and priorities - What will the AHSN do? What will its operating model be? Goals, targets and outcomes - How will we know if the AHSN is working – what are its “deliverables?”

Concern that core function is not clearly stated. The core purpose is about innovation and its diffusion across the NHS. Should be more about “H” and “N” and less about “A” and “S”.

There should be a cadre of generic innovation officers who would work in parallel to the research support officers funded by CLRNs – this would accelerate and streamline adoption and diffusion, and represent a tangible commitment to service improvement.

We can turn the target argument on its head – rather than asking what targets the AHSN should adopt, we could ask how the AHSN can help its partner organisations to achieve their existing targets

Cardiac and stroke should be merged into one cardiovascular disease priority, as this better describes the health challenge facing the region covered by the AHSN.

Should implementation of NICE guidelines be a priority for the AHSN, when this is already a “given” ? NICE Guidance is evidence which has already been appraised and now needs to be put into practice – whether or not through the AHSN. Should the priority actually be to address the challenge to change cultural behaviours to ensure delivery and implementation of NICE guidance in practice and achieve the other objectives of the AHSN? Should this be one of the seven themes?

There needs to be a link to public health and local authorities – the AHSNs should be concerned with making large scale change across populations. Public health intelligence will help the AHSN to know whether the change has been successful.

The AHSN needs to support the commissioning function, not just the providing function, and work with clinical networks on the definition of working standards

The Prospectus contains metrics which are about process. The AHSN will need to measure success in terms of outcomes – e.g. QALYs, health gain.

Developing partnerships with industry may help where there are mutual benefits – but do we also need a code of practice or ethics so that we do not collaborate with inappropriate organisations? Need to ensure effective and appropriate governance models so that the NHS and industry work in synergy.

3

Think outside of Meditech and Pharma industries, and about processes, not just products – Tesco are the industrial partners for Whizz Kidz/Child in a Chair in a Day, and have been very effective. The supply chain/just in time approach they used to speed up delivery could be replicated elsewhere.

Involvement of the LEP (Local Enterprise Partnership) is essential

Duplication of effort is evident across the AHSN area and could be improved.

Another key concern should be to streamline and simplify processes across the pipeline – we should not be afraid to devolve discrete pieces of work to small, effective groups who would deliver on behalf of the whole.

Population health perspective - is it more useful to focus on this, rather than national priorities ?

Prospectus is too busy and prescriptive – the key vision needs to be simpler, with a “strap line” to focus delivery of AHSN. The business plan needs to be shorter, more focused and less repetitive than the Prospectus currently is.

The description of the themes and core functions could be improved – the various elements of the Prospectus could be better aligned.

We need to learn from the HIECs, which had similar tasks and objectives to the AHSN – but it took them a long time to make changes – why?

Maternity and child health should be a “pathfinder” theme – there are currently over 30 active projects in this area covering the whole pipeline – their implementation/development could be accelerated within the AHSN – there is a need for some quick wins to win over the cynics and skeptics

The AHSN needs a website to help to establish the AHSN’s identity. It should be about the AHSN and what it does – it should not try to be an expert resource – it should direct users to looking for specialised information to proven websites

The AHSN has to encourage wide and fast diffusion and spread – but it also needs “blue skies” thinking and to incorporate the breakthrough approach to encourage and reward high flyers.

2. Structure, governance and membership (How will the AHSN be organised and

run? How will members contribute?) The Business Plan (Who does what next)?.

The AHSN does not feel joined up as yet – there remains a lack of clarity across the AHSN region about what is being developed in academia and how this could be addressed for clinicians. A key purpose of the AHSN would be to close this loop and add value in this area.

4

The AHSN’s role is complimentary to but distinct from CRNs.

Strong clear clinical leadership is needed

Workforce implications not are clear - what will organisations be asked to commit to, and are there training and education implications?

Not yet enough engagement with all partners and with all service users – so the “bottom - up pull” which should drive the AHSN has not yet been created.

Bringing together different and disparate partners is a major challenge – the culture needs to be in place to support delivery. Culture change is needed – but can you measure it and recognise when you have it? Likewise – how does one measure improved collaboration when innovation and improvement often take place in silos?

What networks are in place already, and how do we, as an AHSN network bring them things together? Would a “strap line” or over arching theme help to bring all this together?

What is the role of the CQUIN mechanism – it provides the potential to link finances and outcomes/compliance/involvement - will it play a role?

Need to be clearer about how the AHSN manages non - compliance or under performance – the governance principles of 'being a good partner' should apply – the AHSN’s role should be supportive and developmental, not punitive – “all carrot, no stick”

Other levers for change include reputation/kudos, providing targeted resources and support, education and training, and profit sharing. Communities of practice are seen as a means of developing and reinforcing innovation in practice.

AHSN should not increase administration, documentation or data collection requirements for its partners, unless it can exceptionally be justified in the interests of patients, staff or organisations. If it has a performance management role it should align with existing approaches – not duplicate them or create new workloads.

Need a strong upstream link with education and training – get things right at source rather than correcting them later on.

Funding model needs clarity – NHS organisations have to make a tangible financial contribution to their AHSN in order to demonstrate commitment. “In kind” contributions (e.g. staff time) or contributions from other sectors (e.g. industry, E.U.) are unlikely to count, but new income could offset the costs of contributing. This would make a top slicing model more palatable.

5

The collective strength of the AHSN should equip it to attract EU funding. There is potentially huge spend to save capacity, and opportunities to generate new income from this and other sources. From a financial point of view, the biggest gains are probably to be made from aligning academic and industrial interests

A means of aligning funding flows across the network needs to be found

Need to clarify profit sharing arrangements – do financial gains accrue to the whole AHSN, to the organisation driving the change, or are they distributed according to some other principle?

Need to consider how the AHSN will deal with non - public sector organisations which join the AHSN in terms of both financial contribution and administrative arrangements and whether Memoranda of Understanding will be needed for an partners or members.

Developing Intellectual Property mechanisms across the AHSN is important.

North West Coast AHSN Steering Group- 22 October, 2012

Agenda Item 6i - Transition Project Plan PURPOSE

To agree the main outstanding issues for the AHSN and the means by which they will be addressed. From the AHSN’s discussions a bespoke plan will be developed and distributed, and form the basis for the AHSN Steering Group/Shadow Board’s agenda going forward. DISCUSSION The NWC AHSN Prospectus is, to date, the primary document linking the AHSN’s partner and member assets to its aspirations. The document is, however, sparse on detail in respect of a number of areas, particularly in respect of what the AHSN will do, what its Business Plan will contain, and what its objectives will be. The development of a coherent Business Plan is one of a number of urgent issues which need to be addressed alongside preparations for the interview. This is the subject of another paper and will therefore receive only passing mention here. The appended table outlines the key tasks, delivery mechanism and dates. Subject to discussion and agreement by the Steering Group, this deliberately brief outline will be worked up into a detailed plan. It is important to note that in order to meet the timetable for the establishment of the AHSN, some decisions will need to be made at today’s meeting, or shortly afterwards and certainly before the next meeting. Members are also asked to consider capacity issues, and whether there is a necessity to buy in external support for any aspect of the Transition Plan. RECOMMENDATION The AHSN Steering Group is asked to note and discuss the attached with a view to agreeing a full Transition Plan. Philip Dylak AQuA Research Associate 18 October, 2012.

Issue Proposed delivery mechanism

Proposed delivery date

Develop Business Plan (inc. Financial model and objectives)

Eighth Sub Group of the Steering Group/Shadow Board

19 November, 2012

Determination of legal form of organisation and governance arrangements

Proposal by PD to Steering Group prior to next meeting

9 November, 2012 (nb comprehensive supporting documentation, including constitution etc. may take longer to deliver)

Appointment of Shadow Board

Steering Group Chair to issue invite to relevant organisations

Aim to complete process during November so that Shadow Board can assume responsibilities at its meeting on 3 December 2012

Develop Terms of Reference and other governance documentation for the substantive Board

PD to prepare based on existing models (e.g. Monitor Governance Framework)

Terms of Reference to be presented to Steering Group/Shadow Board at its 12 November meeting. Steering Group/Shadow Board to determine need for additional instruments (e.g. Memoranda of Understanding)

Agree and implement process for appointment of Chair and Managing Director (Chief Executive/Accountable Officer)

CEO led Task and finish group of the Steering Group

Process to be presented to Steering Group/Shadow Board at its 12 November meeting. Selection process to be implemented before Christmas, 2012

Agree and implement process for appointment of other AHSN officers

CEO led Task and finish group of the Steering Group

Process to be presented to Steering Group/Shadow Board at its 3 December meeting. Selection process to be implemented before end of January, 2013


Monday 22 October 2012

Agenda Item 6ii. Sub Groups – Feedback

PURPOSE

To update the Steering Group on the structure, and immediate and medium term plans for the seven AHSN sub – groups. DISCUSSION The AHSN has two very immediate concerns. The first is the imminent interview with the DH, which is expected to occur by the end of October or early November. At the time of writing, no date has been offered or agreed. An almost equally pressing need is to transform the Prospectus into a coherent and integrated five year plan for the NWC AHSN. The Prospectus lists a number of priorities, themes etc., and it is clearly very important that these elements are aligned and integrated. The key elements, as described in the Prospectus, are as follows:- 1. The Region’s Health Challenges

AHSN footprint contains very densely and very sparsely populated areas.

Health variations are amongst the most striking in the country.

Cancer, cardiac and stroke, children and maternal health, mental health and long term conditions are identified as areas for health improvement

2. The AHSN’s Priorities

Implementation of the six High Impact Innovations and iTAPP push technologies;

Improvements in cancer, children and maternal health, cardiac and stroke, mental health and long term conditions

Implementation of NICE guidelines relevant NICE Technical Appraisal Guidance in all NHS organisations

Personalised medicine

3. The Six core functions to deliver the AHSN’s priorities are:-

Research Participation

Translating Research and Learning into Practice

Education and Training

Service Improvement

Information

Wealth Creation 4. The AHSN’s Seven Themes

Industry, NHS, HEI Partnerships

Accelerate research

Personalised medicine

Information

Education and Training

Patients and Public

Improve Health Outcomes 5. The five objectives - to counter barriers to health improvement are:-

Reducing health inequalities

Equity of provision of excellent healthcare

Meaningful service user engagement

Integrated cross – sector working

Minimising the environmental impact of healthcare and associated activities

The NWC AHSN has committed to these elements in the Prospectus, so there has to be a system for their delivery within the structure of the AHSN. The AHSN had commissioned the establishment of seven sub - groups to deliver parts of its agenda. Some of these groups never met or met on a virtual basis only, and it is not clear whether any checks were made to ensure that responsibility for all of the elements listed above was vested in one primary sub group, so that no vital issue is omitted from the AHSN’s deliberations. The attached table was prepared to align all of the above elements to the seven sub groups, and distributed to the sub group leads. Although these arrangements may need to change over time, this piece of work has clearly responded to a number of anxieties about where responsibilities lie and who will be responsible for delivery.

The sub group leads have been asked to undertake the following, as soon as possible:- 1. Establish a Programme of Sub Group Meetings 2. Establish a mechanism for monthly reporting to the AHSN Steering Group/AHSN

Board (n.b. a central “chaser” system has been established) 3. Identify “Deliverables” for the Sub Group’s area of interest - at least one

deliverable to inform preparations for the DH interview, followed by further deliverables as appropriate to the steering group theme, for development into the Business Plan

(nb in view of the time available, it will not be possible to circulate the interview deliverables in advance of the Steering Group meeting). RECOMMENDATION The AHSN Steering Group is asked to:- 1. Note the establishment of the seven sub - groups, and facilitate their effective

functioning; 2. Endorse the monthly reporting requirement; 3. Agree the areas of responsibility as allocated to the sub groups (see Annex 1) 4. Discuss and agree the “deliverables”; 5. Discuss whether any further sub groups or other structures need to be

established – for example, are PR and communications, and finance and business planning sub groups also required? Are the responsibilities allocated to the Service Improvement Sub Group manageable?

Philip Dylak AQuA Research Associate 16 October, 2012.

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Innovation Health and Wealth Implementation Board Tuesday 16th October 10.30-12.00

NHS Innovation Fellowship Scheme Summary Purpose

This paper sets out the designs for the scope and operation of the Fellowship Scheme:

The Fellows o How many will there be and how long will their tenure be o The Role of the Fellow and the different types of Fellows o The benefits of being a Fellow and how they will be recruited o Recommendations for the first intake of Fellows

How will Fellows be accessed by the NHS o Programme of events o Coaching o Future expansion

Promoting the Scheme within the NHS

Organisation of the Scheme o Role of a Host and approaches to identifying a Host organisation o How the scheme could be funded – including summary of expected costs o IT systems to support the scheme

The set up of an NHS centric steering committee to govern the scheme

Background summary IHW made a commitment to set up an NHS Innovation Fellowship Scheme so that the best innovators can share their knowledge, experience and expertise with the NHS.

The intention of this commitment is to establish an innovation fellowship scheme with sufficient kudos and standing to attract the worlds most prominent and respected leaders from the widest possible range of disciplines, sectors and countries. The Fellows will work remotely to share knowledge, experience and learning with Chief Executives and Boards across the NHS to help them champion innovation in their organisations.

Next Steps o Commence identification of the host organisation o Engage with potential fellows to test the ‘ask’ o Begin recruiting Fellows o Market the scheme within the NHS o Organise the first year of events in conjunction with identifying the host. o Announce the Fellowship scheme and the first Fellows at the Innovation Expo in

March 2013. Recommendations to the IHW Board 1) Endorse the recommendations of the Task & Finish Group and agree the next steps 2) Arrange the shortlist of Fellows within each category in priority 3) To advise on the ideal mix of the first 15-20 Fellows for year 1 4) Provide a steer on the options for funding the Fellowship 5) Advise on appropriate policy for paying Fellows expenses and/or making philanthropic

donations for their time 6) Advise on the Steering Committee membership

Version 8 for IHW Board

Innovation, Health and Wealth

NHS Innovation Fellowship Scheme Executive Summary The Innovation Fellowship Scheme is itself an innovative approach to engaging and supporting senior leaders with promoting and developing innovation across the NHS. It aims to bring together highly successful innovators from around the world with senior leaders from the new NHS structure to help place innovation at its core. Through annual recruitment, a community of Fellows will be developed as a high profile resource to the NHS and to the worldwide agenda of improving healthcare to meet future challenges and opportunities. Following extensive research and discussion, this paper describes how such a Fellowship could be successfully introduced to the NHS, suggesting a programme of activities for the first year of the scheme; identifies a shortlist of potential Fellows and sets out the organisational requirements for the scheme to be set up and maintained. 1. Background Innovation, Health and Wealth sets out recommendations to create a culture and system for innovation in the NHS that continually scans for new ideas and takes them through to widespread use. This system requires the NHS to work with industry, academia, staff and patients, to set an agenda for change and delivery. Key themes that emerged from the review were developing the capacity and capability of our people to innovate, creating a culture of innovation in our organisations and strengthening leadership to support and drive innovation. The review recommended the creation of an NHS Innovation Fellowship Scheme so that the brightest and best innovators can share their knowledge, experience and expertise directly with the top decision makers in the NHS. This paper describes the work of the NHS Innovation Fellowship Task and Finish Group whose membership is attached at Appendix 1. 2. Overview The purpose of the NHS Innovation Fellowship is to inspire and support NHS leaders to champion innovation and develop an innovative culture.


It will do this by

Attracting valued and recognised, national and international innovators with relevant experience and the motivation to contribute to the ambition of the NHS

A critical mass of diverse Fellows will be recruited that come from a range of sectors, health, industry and academia and with a range of experience

They will share experiences and achievements with individuals and organisations in the NHS with the power to effect change

They will help NHS leaders to make innovation central to strategic plans

The Fellowship to be hosted by a credible organisation that can recruit excellent Fellows and manage and develop the actions and interactions with the NHS.

And over time this will create a highly valued and world wide learning community.

This Fellowship sits alongside a number of other IHW initiatives. Most critically the Strengthening Leadership and Accountability for Innovation programme – it is envisaged that the Innovation Fellows will be pivotal in providing NHS Chief Execs and Boards with the inspiration and guidance necessary to meet the requirements set out by this initiative and make innovation central to strategic plans. Furthermore, Academic Health Science Networks (AHSNs) are partner organisations that will bring together local NHS, Higher Education and Industry to focus on improving the identification, adoption and spread of innovative health care across a network. In addition, the NHS Fellowship scheme will complement the other training programmes within the NHS and Industry Joint Training and Education programme seeks to bring senior managers and clinicians together with industry colleagues to learn and train together; the Education and Training T&FG is working to hard-wire innovation into educational curricula, training programmes and competency frameworks at every level. The term Fellowship commonly applies to sponsored academic sabbaticals for individuals. However, as we have described this Fellowship to others, they have understood the concept and aims and the terminology of Fellow to describe the role we want to develop and the innovators we want to attract. Fellowship schemes with a degree of similarity are successfully run by the NHS Institute for Innovation and Improvement1 and by the TED2 organisation. These schemes provide support for the approach we plan to take without competing. We have had 3 design principles in mind as we have developed our proposals:

Making sure that Fellows are able to make a positive and real contribution to the NHS and its drive for innovation

1 http://www.institute.nhs.uk/improvement_faculty/information/introduction.html 2 http://www.ted.com/pages/about_fellows_program


Being confident that we can attract high quality Fellows

Developing a Fellowship that will be durable and that will develop over time.

3. What kinds of Innovators? Innovator is a broad term. Considering different types of innovators helps us identify those that have relevant experiences to share with the NHS and to recruit a cohort of Fellows that can bring a range of perspectives. The Task and Finish Group has come up with the following classifications (Appendix 3 contains a shortlist of potential fellows for each category): Innovation inventors: could include people who have a track record of bringing high profile innovative ideas to fruition such as James Dyson. Change innovators: are people who have brought an innovative change or idea to a large organisation and been responsible for driving its adoption and diffusion throughout their organisation. Tesco’s Terry Leahy would be an example. Health/Social care innovators: individuals who have a demonstrated history of bringing innovative solutions to health and social care issues to fruition, or those who have exerted an influence on healthcare development. Examples would be Sangita Reddy, Kenneth Kizer and Don Berwick. Innovation Strategists: individuals who have made a successful career of studying innovation, such as Clayton Christensen and Rosabeth Kanter Social Media Innovators: use the power of the internet to enable the public to contribute to and drive change and improvement. The Lego Click community is a good example of this. Investors in Innovation: individuals who have a track record of investing in successful healthcare ventures and bringing innovative ideas to the marketplace. For the Fellowship to be successful, we need to attract and recruit a diverse group of successful innovators. These don’t have to be household names. 4. The Role of a Fellow The aim of this Fellowship is to recruit highly successful innovators from around the world to come together with leaders and clinicians from the new NHS structure to help the NHS place Innovation at its core.


We would aim to recruit approximately 15 individuals to undertake this new role for a 3 year period starting in March 2013 with a launch at the Healthcare Innovation Expo. There would then be annual recruitment of a similar number of Fellows. The minimum time commitment for a Fellow would be 3 days per annum. At the end of their 3 years, Fellows could request an extension or be invited to join an alumni. The nature of this engagement is key to the success of the Fellowship. The people we have canvassed would value the opportunity to interact with Fellows who bring and apply their experience and learning and use it to stimulate and challenge our orthodoxy. At their best, these interactions are 2-way with the Fellows gaining from their interactions with talented people from the NHS. What people don’t want are descriptions or stories of innovations in other settings, that may be impressive and interesting, but don’t apply to our situation. More crudely, people have told us that they want high quality and relevant engagement, not promotional transmission. What they want is to actively participate in thinking and debate with Fellows. To be successful we need to carefully design the nature of engagement. 5. A Recommended Programme for the First Year We propose an initial structure to the fellowship scheme that utilises a combination of face to face debate sessions, short seminars (both face to face and remote) and coaching interactions. The debates and seminars will provide the inspiration and initial practical advice for NHS leaders to make plans for organisational change. Further practical support on implementation and problem solving will be provided via coaching and 1:1 interactions. Participation in face to face events by NHS leaders will not incur a cost to the participant and will be by privileged invitation. In the first year of the Fellowship, we are recommending 3 activities. 5.1 A “Davos-style” Event This would be a well planned and facilitated 2/3 day event that brought Fellows together with senior and influential people in the NHS for a high quality discussion and debate. We have used Davos as a short-hand because of its brand recognition as an influential and high quality event. The annual meeting of the World Economic Forum has its annual meeting in Davos each January, attended by around 2000 participants who discuss and debate key issues of global concern over 5 days. Our research has shown that the design and facilitation of these events is crucial. For example, the Ditchley Foundation (www.ditchley.co.uk) is based in Oxfordshire and organises around 12 of the events that we have in mind each year. The Foundation was established in 1958 to advance international


learning and to bring transatlantic and other experts together to discuss international issues. We have spoken with Professor Ted Marmor3 who has attended Ditchley conferences and describes their strength as being events that stimulate leaders in a way that attending is an honour as well as a pleasure and the style of conversation and ‘chairing’ of plenary gatherings and use of small groups promote discussion of the topic in ways that turn out to be interestingly different. Their most recent conference was called “Putting science, government, business and innovation together” and was chaired by Sir Keith O’Nions. Preliminary discussions have been held with Ditchley who would be happy to work with us on this event – maximum capacity is 46 delegates including the fellows. The event would be totally self contained with exclusive use of the mansion, its facilities and bedrooms plus access to the surrounding estate for leisure activities The tried and tested programme allows for 5 discussion sessions throughout the day (including an evening session). A typical day would look something like this:

Breakfast

Session 1 9:30-11:00

Coffee

Session 2 11:15-12:45

Lunch

Session 3 2:30-4:00

Session 4 4:30-6:00

Dinner 7:00/7:30

Session 5 9:00-10:30 When designing this event we will need to consider how people from the NHS are identified/ invited to attend. Ensure people from new NHS structures – including ASHNs. It is hoped that this would become an annual event and would expect Fellows to attend at least one during their 3 years. 5.2 Innovation Seminars Seminars would be run once or twice a month at most and there would be an expectation that each fellow would lead one or two seminars during their tenure (In the first year of the scheme’s operation each fellow would be expected to lead one seminar. Seminars would be run either in person or as WebEx events. All of these would be recorded for further dissemination (probably via the IHW web portal).

3 Professor Emeritus of Public Policy and Management, Yale.

http://mba.yale.edu/faculty/profiles/marmor.shtml


We are working with the NHS Institute for Innovation and Improvement and a number of Health Education agencies on the design of the face to face and WebEx seminars. We propose the following format for the 1st year:

2 seminars to take place at major events (for example the NHS Confederation conference or the Healthcare Innovation Expo) of 1-2 hours in length involving 1 or 2 fellows

2 standalone face to face seminars in the UK of 2-3 hours in length involving 2 fellows per seminar

7-8 interactive WebEx seminars of 1 hour in length involving 1 fellow per seminar (WebEx seminars will be supported by professional video and audio and may be hosted in UK or fellows country of residence)

5.3 Innovation Fellows Time Bank The balance of time provided by the Fellows will be used to deliver the key aim of the scheme by providing NHS Leaders with direct coaching around implementing innovative change. For those that are able to commit additional time, they would be able to 'deposit' an amount of time for a defined period (perhaps periods where they have reduced demands on their time from other commitments). This time could be used by senior and influential leaders and clinicians to gain advice on particular issues from fellows who have been allocated to them (by the scheme’s host) or to take part in remote problem solving events (participate in action learning sets, web Jams etc). It is proposed that a community using social media tools will be set up to facilitate and manage these interactions – this community will be moderated by the host organisation. 5.4 Developing the Role in Future Years We have deliberately limited the recommended activities for Fellows in their first year to these three. We will learn a lot in this first year about how the role can be developed and expanded as the number of Fellows increase and we develop an alumni. Ideas that have come in discussion include direct links with Academic Health Science Networks (for example, chairing an AHSN) and developing a database of Fellows and alumni expertise and interest to support further networking between Fellows and with the NHS.

In future years we would like to explore expanding the target audience for the NHS Innovation Fellowship from the top decision makers in the NHS to healthcare management leaders around the world. By engaging with Chief Executives from both developed and developing healthcare systems globally, a number of benefits for the fellowship scheme could emerge:


1) Attract high profile fellows who are interested in engaging with the

world’s healthcare leaders

2) Give NHS Chief Executives the opportunity to network with their global counterparts, creating links and exchanging experience of their healthcare populations, issues and solutions

3) Raise the profile of the NHS Innovation Fellowship scheme on the international stage

4) Provide an opportunity to showcase the NHS, through its Chief Executives, to the world’s healthcare leaders

5) Improve the sustainability of the fellowship programme by increasing the target audience and potentially emulating the success of events such as the world economic forum.

6. Attracting Innovation Fellows A short recruitment document and video will be produced to support the recruitment of Fellows – outside expertise will be bought in to facilitate. We would be looking for a minimum commitment of 3 days per annum from each Fellow. We are promoting this as a rewarding role for Fellows in the following way:

This is a unique opportunity to make a direct and lasting contribution to the NHS and therefore the health of the people of England.

The Fellowship will be recognised nationally and internationally as bringing together the best innovators. We will only recruit around 15 each year and these appointments will be high profile.

The NHS is full of committed and talented people and we would expect Fellows to gain from their interaction.

We would also want Fellows to benefit from networking with each other through, for example, the “Davos style” event or sharing masterclasses and seminars. We would aim to create a community of Fellows using private social networking tools.

We would want to show our appreciation for the contribution made by Fellows through recognition and networking opportunities. This would include an Annual Fellows dinner bringing together senior and high profile people from Government, academia and business.

We would want the Fellowship scheme to result in a lasting community of innovators, providing the Fellows with new connections and the potential for future partnerships


It may be possible to pay travel expenses and/or to consider an honorarium payment to a host organisation/philanthropic cause.

An outside organisation is being engaged to test these principles with potential fellows and they will be modified as a result of feedback if necessary. 7. Attracting NHS Involvement Discussions with a number of senior leaders about the Innovation Fellowship suggests that our implementation programme will need to include an internal engagement and marketing strategy. Common first reactions can be that the Fellowship sounds gimmicky or about household names “telling” not engaging or helping with our agenda. However, when the scheme is described further, people quite quickly become attracted to its potential to make a good contribution. A programme of internal facing activities to engage the target NHS audience will therefore be carried out. Such activities may include:

Direct discussions with a sample of the target audience to assess the mood

Develop a plan to ‘market’ the scheme to the NHS audience if necessary

Potentially identify Fellowship Advocates within the NHS target audience to spread the work and champion the scheme

8. Organising the Fellowship 8.1 Recruiting the first cohort A long list of potential Fellows has been drawn up with input from multiple stakeholders. This list has been reduced by the T&FG to a shortlist of 35 (appendix 3) from which we recommend the first 15 year 1 Fellows are selected. We request that the IHW board members arrange this list in order of preference. Individuals will then be sequentially approached for involvement by Dept Health or an external agency as appropriate. 8.2 Hosting Arrangements We have considered the organisational arrangements required to support this Fellowship. An organisation is required that can “host” the Fellowship and undertake the following tasks:

Annual and ongoing recruitment of high quality Fellows

Contact point for all administrative needs for Fellows


Organising and coordinating Fellowship events (initially, “Davos”, Masterclasses and Timebank).

Organising the Innovation Fellowship Steering Group (see 8.3 below)

Organising Annual Dinner

Promoting the Fellowship

Evaluating the Fellowship We have looked at two options for organisational hosting of the Fellowship:

By the Academy/ Network of Academic Health Science Networks

By an external organisation 8.2.1 The Academy of Academic Health Science Networks This option was seen to have many advantages. It would place the development of the Fellowship at the heart of the innovation movement in the NHS which could maximise its potential to develop roles for Fellows that add the most value. The disadvantage is the timing. AHSNs are only just forming and while the concept of a network/ Academy of AHSNs is expected, the detail is not yet worked up. 8.2.2 An External Host Organisation A proposition will be developed with external expert assistance that will detail the general responsibilities of the host (see 8.2) along with details of the financial model (IHW Board input sought on this in section 8.5) and clear deliverables (especially for 2013). An external facing competition will be launched to allow individuals organisations or a collaboration of organisations to bid for the honour of running this prestigious scheme. The completion will allow time for the host to engage with the IHW teams to ask questions and shape their proposals before the closing deadline. Detailing the plans for running the activities that have been identified in year 1 as part of this paper will be an integral part of the competition so that the selected host can hit the ground running. 8.3 Innovation Fellowship Steering Group In addition to the hosting of the Fellowship we also recommend the creation of a Steering Group to oversee its ongoing development and direction and to oversee the work of the host.


Membership of the Steering Group would include senior representation from the NHS Commissioning Board, Academic Health Science Networks, the Chief Executives of the NHS Leadership Academy and NHS Improvement, the Academy of the Medical Royal Colleges and NHS Innovation Fellows. It would be organised and attended by the host organisation. Outline Terms of Reference:

Oversee the work of the host.

Evaluate effectiveness of Fellowship (including feedback from NHS participants)

Review feedback from Fellows

Develop and shape the Fellowship in response to the progress and needs of the NHS.

A small but useful housekeeping suggestion would be to hold the AGM for the Steering Group on the same day as the Annual Fellowship Dinner. 8.4 An innovative information System to support the Fellowship To enable the host organisation to ensure that NHS Leaders are connected to the most appropriate NHS Innovation Fellows for coaching, to manage requests for assistance and to manage the amount of time each fellow has committed to the scheme, an information technology solution will be needed. This solution will also support the concept of providing a secure community for Fellows to communicate with each other (as part of the benefit of being a Fellow) as well as ensuring that the whole scheme works as a community. IBM have indicated their willingness to work with Dept Health on setting up a system that will cover the below functions. A proposal is currently being discussed and worked up that will likely contain options for a reduced functionality system on trial basis.

Ability to hold full details and interests of the NHS Fellows in a closed

system (and a separate list of alumni)

Ability to hold details of senior NHS leaders

Full list of NHS members and NHS Fellows would need to be kept

separate and only accessible by the host organisation

The host will need use this system to match the needs of the NHS with

the interests of the fellows when organising events and responding to

new requests for assistance from the NHS (Potentially even an area

where NHS employees can post requests for assistance and then be

linked to the correct Fellow by the host)

Ability to add new members (either Fellows or NHS employees) as the

scheme develops


Ability to set up specific communities and integrate new members into

them as appropriate. Examples of communities would be

o A community of Fellows

o A community of NHS members

o A community of Alumni

o Cross cutting communities based on interactions:

Communities for participants at a particular event to

enable follow up discussions

Community for brainstorming solutions to problems

presented by the NHS

Community for NHS employees to post requests for more

in depth assistance

Community where fellows can view problems posted by

NHS members and indicate a desire (to the host) to get

more involved

8.5 Costs and Funding The cost of setting up the Fellowship scheme will be met from IHW and include running the host competition, internal and external market research and marketing, production of information for fellows and participants, set up of IT systems to support the fellowship. 8.5.1 Estimated Costs It is estimated the costs of running the Fellowship Scheme for Year 1 (not including general Host Administration costs) will be: £450,000 These costs support the delivery of a high quality set of activities in keeping with the profile of the scheme and the Fellows, delivered free to participants. A breakdown of activity costs is provided below (agency fees have been used as a proxy for host facilitation expenses): Davos style healthcare forum: A well planned and facilitated 2/3 day event bringing together Fellows and senior/influential people in the NHS for a high quality discussion and debate. Top line costs for a 2 day event involving 9 or 10 fellows and 35 NHS participants would be £55, 000 (Including meals, accommodation, onsite and pre meeting facilitation etc)

Face to Face Seminars:

Top line costs for a Face to Face Seminar for 50 delegates at the Innovation Expo would be £28,000 (Including delegate rates, venue set-up, pre-meeting and onsite facilitation an filming for later web access)


Top line costs for a Face to Face Seminar for 40-50 delegates at NHS Confederation Conference would be £34,000 (Including session rates, room set-up, pre-meeting and onsite facilitation and filming for later web access)

Top line costs for two Standalone Face to Face Seminars for 40 delegates £80,000 (£40,000 each - including venue hire and set-up, pre-meeting and onsite facilitation, printed materials and filming for later web access)

Total Face to Face Seminar Costs Approx: £142,000 Web Ex Seminars

Top line costs for 8 WebEx based seminars with live Q+A and broadcast video would be £125,000 (£15,000 each plus annual WebEx Licence - including studio hire and set-up, pre-meeting and onsite facilitation, printed materials and recording for later web access)

Information Technology Top line costs for Information Technology to support the Fellowship would be: £115,000 This includes a system to facilitate/manage fellows’ interactions with the NHS and development of a web platform to support off-line viewing of Face to Face/WebEx Seminars plus on-line delegate registration for events. 8.5.2 Funding Options There are effectively two options to fund the future years of the Fellowship scheme. The first is for the costs to be met by the NHS Commissioning Board. The second would be to ask the host organisation to fund it through sponsorship or charging for participation in the Fellowship events. Not surprisingly, the T&FG thought the first option would be best. There are concerns that sponsorship and charging for events would detract from the brand of the Fellowship and limit participation. However, this is something that could be tested as part of the search for the host organisation. Regardless of the funding route chosen, the T&FG strongly recommend that there is not a cost of participation to our target audience in the NHS. To gain their participation and engagement to events they should feel they have received a privileged invitation. 8.6 Timescales and Implementation A high level project plan is included at appendix 2 of this paper. If approved, the next steps include appointing an external agency to commence recruitment of the first Fellows, market the scheme within the


NHS, organise the first year of events and run a competition to identify the host organisation. The aim is to introduce the Fellowship and announce the first Fellows at the Innovation Expo in March 2013. 9. Desired Outcomes of the Fellowship Scheme The following are some benefits that we would desire to see as a result of the fellowship scheme: • NHS leaders are more open to innovation and prepared to try out

innovations and innovative approaches. • NHS leaders champion innovation and innovation is central to strategic

and delivery plans. • A more innovative culture in the NHS resulting in better spread of

innovation (through leadership) 10. Recommendations The IHW Board is invited to comment on this paper and the work of the T&FG. In particular the Board is asked to:

10.1 Arrange the shortlist of Fellows within each category in priority order (ref.Appendix 3)

10.2 To advise on the ideal mix of the first 15-20 Fellows for year 1

10.3 Provide a steer on the options for funding the Fellowship (ref 8.5.2)

10.4 Advise on the Steering Committee membership (ref 8.3)

10.5 Advise on appropriate policy for paying Fellows expenses and/or making philanthropic donations for their time (ref. 6. last bullet)

10.6 Agree implementation timescales and next steps (ref 8.6)


Appendix 1 T&FG membership

T&FG Lead

Andrew Liles, Chief Executive, Ashford and St Peter’s Hospitals

NHS Foundation Trust

T&FG Members

Alistair Henderson, Chief Executive, Academy of Medical Royal

Colleges

Candy Morris, Senior Consultant Strategic Projects, NHS South

of England

Tony Young, Professor of Medical Innovation, Anglia Ruskin

University

Rob Berry, Head of Innovation, NHS South of England (East)

Keith Chantler, Director of Academic Affairs and Innovation,

Central Manchester University Hospitals NHS

Foundation Trust

Johnny Lundgren, Vice President, Becton Dickinson

Paul Lamba, Director of Medical Affairs, MSD

Sheila Mitchcell, Mitchell Damon Partners

With thanks to Stephen Thornton and the Health Foundation who were

particularly helpful with suggesting potential Fellows for our long-list.


Appendix 2 – Timeline for Year 1


Appendix 3 - Short List of Fellows

Innovation inventors: people who have a track record of bringing high profile innovative ideas to fruition.

1. Sir James Dyson – British industrial designer and founder of the Dyson

company James attended London’s Byam Shaw art school but painting beautiful objects wasn’t enough. James wanted to make, and the Royal College of Art allowed just that. James studied architecture, but instead of colonnades and cladding, robust marine engineering was the order of the day. He developed a flat-hulled high-speed landing craft and, with it, his passion for engineering. Pretty soon, he’d also developed a new kind of wheelbarrow – one with a big fat ball that didn’t sink into mud and chunky feet for stability. All the while learning to take risks, make mistakes and use frustration as a fuel for creativity and solving problems.

2. Bill Gates – Founder Microsoft.

Needs no explanation

3. Alexandra Drane - Founder of Eliza Corporation

Pioneer and leader in Health Engagement Management and one of Entrepreneur magazine’s “100 Brilliant Companies.” The company’s intelligent, tailored interactions—including automated calls powered by a patented speech recognition engine, rich web and multi-modal delivery platform and proprietary sophisticated data analytics—make health and healthcare information more accessible, more actionable and more engaging. Examples of Eliza’s impact include increasing the number of patients who get their recommended diabetes screenings by 76%; more than doubling prescription refills over a six-month period; quadrupling participation in an online smoking cessation program; and boosting younger members’ perceptions of their health plans’ brands beyond what far more expensive traditional advertising campaigns deliver.

4. John Moore, MIT Media Lab – invention and getting research prototypes to general implementation

John is a physician and technologist working to fundamentally change the role that patients can play in their care by empowering them with knowledge, understanding, confidence, and channels for communication. He is studying the effect that new technology-mediated paradigms for doctor-patient collaboration can have on education, adherence, and behavior change. Moore received both a BS in biomedical engineering, and a medical degree from Boston University. Before attending medical school, he was a Fulbright Scholar in Belgium, where he conducted clinical engineering studies on neurological movement disorders


Change innovators: people who have brought an innovative

change or idea to a large organisation and been responsible for

driving its adoption and diffusion throughout their organisation.

5. Terry Leahy – CEO Tesco 1997-2011

Leahy is known for transforming the supermarket industry in Britain, growing Tesco to the largest chain in the country and disrupting the businesses of its competitors. Experts credit Leahy’s success to his hands-on style and marketing prowess, while Leahy places focus on experience and low-key leadership. Since Leahy became chief executive in 1997, Tesco has taken the lead in Britain and, unlike its domestic competitors, has successfully expanded into other parts of Europe and Asia. His creative leadership enabled Tesco to successfully take risks on new products, store formats and lines of business, including expanding the company’s non-food product line.

6. Mike Brown, Managing Director, London Underground and London Rail

Mike Brown joined London Underground in 1989 and became the Chief Operating Officer in 2003. He left London Underground in 2008 and for two years ran Heathrow Airport for BAA during the delivery of a multi-billion pound investment programme. As Managing Director of London Underground, Mike is responsible for operating services that see more than one billion journeys every year and for leading the largest line upgrade and investment programme the Underground has ever seen. Mike was appointed as Managing Director for London Rail in November 2010 and is responsible for integrating National Rail services with London's transport network and taking forward major rail projects in London, including London Overground. London Rail is also responsible for London Overground, DLR and London Tramlink.

7. General Sir David Richards - Chief of the Defence Staff, MoD

The professional head of the UK Armed Forces and the principal military adviser to the Secretary of State for Defence and the Government. Involved in implementing the Strategic Defence and Security Review.

8. Lord Gus O'Donnell

After lecturing at Glasgow University he joined the Treasury as an economist in 1979. He became Chancellor Nigel Lawson's press secretary in 1989, then John Major's. He was the UK's executive director to the International Monetary Fund and the World Bank. In 2002, he was made Permanent Secretary at the Treasury and Cabinet Secretary in 2005, announcing his retirement in October 2011. Among his many notable achievements was helping to shape the U.K.’s coalition government headed by Prime Minister David Cameron in 2010.

9. Louis Gerstner Jr – Ex IBM CEO

Gerstner was chairman of the board and chief executive officer of IBM from April 1993 until 2002 when he retired as CEO in March and chairman in December. He is largely credited with turning around IBM's fortunes. The first outsider to head the computer giant, Gerstner inherited an organization crippled by bureaucracy and created a culture that placed a premium on continually adapting business practices to better serve customers. Gerstner's fierce, competitive spirit and tough-as-nails management style were not for everyone, and Gerstner made his fair share of enemies. When Gerstner left IBM in 2002, the company was once again a relevant player in the technology market. In 2003 IBM, the world's top provider of computer


hardware, generated $89.1 billion in revenue. As of 2004 it was one of the largest providers of software, being second only to Microsoft, and semiconductors. IBM's ever-expanding service arm was the largest in the world. The key to IBM's overall turnaround was Gerstner's decision to take the company away from its roots as a hardware manufacturer and lead it into services, which included everything from consulting on the design of corporate systems to running a company's e-commerce operation. The company's global services unit, which Gerstner started, was an industry paragon.


Healthcare innovators: individuals who have a demonstrated history of bringing innovative solutions to healthcare issued to fruition, or those who have exerted an influence on healthcare development. 10. Sir Andrew Whitty – Chief Executive Officer of GlaxoSmithKline.

Credited with driving fundamental change in the operation of the organisation. Andrew has served in numerous advisory roles to Governments around the world including South Africa, Singapore, Guangzhou China and the UK, where he is currently a member of the Prime Minister's Business Advisory Group and is the Lead Non-Executive Director for the Department for Business Innovation and Skills. He was awarded a Knighthood for services to the economy and to the UK pharmaceutical industry in the 2012 New Year Honours List.

11. Jonathan Sackier - Professor at George Washington University

Trained in Britain as a surgeon and recruited to the USA in 1989 he helped lead the laparoscopic surgery revolution. He founded, and funded the Washington Institute of Surgical Endoscopy, a center for education, research & innovation. He is a Visiting Professor of Medicine & Surgery at the University of Virginia and his activities in basic and clinical research funded by multiple grants have led to many publications, chapters and books. He has served multiple journals as editor or reviewer, has been involved in medical societies at the highest level and has been honored for his work in many countries.

12. Lord Ara Darzi – NHS

Research led by Professor Darzi is directed towards achieving best surgical practice through both innovation in surgery and enhancing the safety and quality of healthcare. His contribution within these research fields has been outstanding, publishing over 600 peer-reviewed research papers to date. In recognition of his outstanding achievements in research and development of surgical technologies, Professor Darzi was elected as an Honorary Fellow of the Royal Academy of Engineering, and a Fellow of the Academy of Medical Sciences.He was knighted for his services in medicine and surgery in 2002. In 2007 Professor Darzi was introduced to the United Kingdom’s House of Lords as Professor the Lord Darzi of Denham and appointed as Parliamentary Under-Secretary of State at the Department of Health. He relinquished office in July 2009 when he was appointed the United Kingdom’s Global Ambassador for Health and Life Sciences, and Chair of NHS Global as well as United Kingdom Business Ambassador, an appointment re-confirmed in 2010 by Prime Minister David Cameron. Lord Darzi was appointed as a member of Her Majesty’s Most Honourable Privy Council in June 2009.

13. Sir John Bell – Oxford

Regius Professor of Medicine. He was appointed by the Chancellor of the Exchequer in 2006 to Chair the Office for the Strategic Coordination of Health Research (OSCHR), the body responsible to co-ordinate the research functions of the NIHR and the MRC. In 2008 he was made a Fellow of the Royal Society and was made a Knight Bachelor for his services to Medical Science. He has been President of The Academy of Medical Sciences since 2006. His research programme has contributed to clearer understanding of genetic determinants of susceptibility in Type 1 diabetes and rheumatoid arthritis and also of the molecular interactions on the surface of the T-lymphocyte associated with immune activation. He has helped to pioneer a large number of high-throughput genomic methodologies applied to biomedical science,


including programmes in structural genomics, ENU mutagenesis and genetics. He is a founding director of three biotechnology start up companies

14. Sir Bruce Keogh – NHS CB Medical Director

Sir Bruce Keogh is Medical Director of the National Health Service in England. He is responsible for the quality framework, clinical policy and strategy and postgraduate education of doctors, dentists and pharmacists and postgraduate training of clinical scientists. He was a British Heart Foundation Senior Lecturer and consultant cardiothoracic surgeon at the Hammersmith Hospital in London before moving to the Queen Elizabeth Hospital in Birmingham, where he became associate medical director for clinical governance and the cardiac surgical service lead. In 2004 he was appointed Professor of Cardiac Surgery at University College London and Director of Surgery at the Heart Hospital. He has been president of the Society for Cardiothoracic Surgery in Great Britain and Ireland, Secretary General of the European Association for Cardio-Thoracic Surgery and president of the Cardiothoracic Section of the Royal Society of Medicine. He remains International Director of the US Society of Thoracic Surgeons. He has served as a Commissioner on the Commission for Health Improvement (CHI) and the Healthcare Commission and was knighted for services to medicine in 2003.

15. Margaret Chan – DG WHO

Starting her second, five-year term as WHO Director-General, Margaret Chan continues as the world's most influential proselytizer for strengthening healthcare systems and single disease initiatives. Her latest alarm bell: an impending post-antibiotic era, where first-line antimicrobial are at risk of becoming useless, including many of the drugs that treat malaria, TB and HIV/AIDS. Chan encountered challenging circumstances in her first term, most notably the H1N1 outbreak in 2009 which necessitated the international distribution of 78 million vaccine doses and the declaration of an worldwide pandemic. In her second term, she plans to continue programs such as Every Woman, Every Child which are dedicated to meeting the U.N. Millennium Development Goals. Prior to work with WHO, Chan served as the first female director of Hong Kong's Department of Health, where she led the fight against bird flu and SARS.

16. Don Berwick – Institute for Healthcare Improvement

As head of IHI, Dr. Berwick can take credit for driving numerous national and international projects to improve the quality of healthcare processes, hospital standards and medical outcomes. The venture we like best is the Hospital Improvement Map, an online tool to guide administrators and physicians across the "confusing landscape" of reform demands, and down the "reliable routes" to better care. It launches in September, and will be free. He patronizes the work of other list-members, including: Gawande's surgical safety checklist and Moore's IMP.org. Besides many other leadership positions and board seats, Dr. Berwick teaches at Harvard Medical School and the Harvard School of Public Health.

17. Sangita Reddy – Exec director Apollo Hospitals

Apollo Hospitals is a major hospital chain based in India, Several of the group's hospitals have been among the first in India to receive a form of international healthcare accreditation. Under sangita’s stewardship, Apollo Hospitals in Hyderabad has emerged as Asia's first Health City, and it has introduced multi-dimensional holistic healthcare to India. In addition, Ms. Reddy is managing director of Apollo Health Street. Under Ms. Reddy's guidance, Apollo has become a leading offshore services firm that provides consultancy to some of the largest payers and providers in the U.S. - operating out of three countries - the United States, the United Kingdom, and India. Ms. Reddy has been a pioneer in advocating the benefit of a global delivery


model - through rural hospitals , outreach camps, Telemedicine etc. Apollo Telemedicine Networking Foundation(ATNF), a not-for-profit organization, is a part of the Apollo Hospitals Group. It is credited with being the first to setup a Rural Telemedicine centre in 1999 in Aragonda (in Andhra Pradesh). Today, ATNF has emerged as India's single largest turnkey provider in the area of Telemedicine with over 125 peripheral centers including 10 overseas. More than 71,000 teleconsultations in 25 different disciplines have been provided Patients have been evaluated from distances ranging from 200 to 7500 km. Commissioning the world’s first VSAT enabled, modern secondary care hospital in a village, at Aragonda, Andhra Pradesh, India on 24th March 2000

18. Kenneth Kizer – Director of the Institute for Population Health Improvement, UC Davis Health System

Distinguished Professor, University of California Davis School of Medicine (Department of Emergency Medicine) and the Betty Irene Moore School of Nursing. He is an internationally respected and sought after health care thought leader and one of very few persons elected to both the Institute of Medicine of the National Academy of Sciences and the National Academy of Public Administration. His previous positions have included: President, CEO and Chairman of Medsphere Systems Corporation, the nation’s leading commercial provider of open source healthcare information technology; founding President and CEO, National Quality Forum, a Washington, DC-based quality improvement and consensus standards setting organization; Under Secretary for Health, U.S. Department of Veterans Affairs and chief executive officer of the nation’s largest healthcare system; Director, (former) California Department of Health Services; and Director, Emergency Medical Services Authority, State of California. He has served on the U.S. Preventive Services Task Force and as Chairman of the Board of The California Wellness Foundation, the nation’s largest philanthropy devoted to health promotion and disease prevention, as well as on the governing boards of managed care and health IT companies, several foundations and various professional associations and non-profit organizations. He also has served as an advisor to numerous foreign countries on health-related matters

19. Atul Gawande - systems innovations in healthcare (US)

Surgical safety checklist. You know him for his books and the New Yorker piece on McAllen, a narrative rendition of Wennberg's life's work. While Dr. Gawande's writing makes a valuable contribution to educating the public on the healthcare system's (dys)function and economics--and earned him a MacArthur award--we list him for his quest to reduce error rates in surgical ORs. A seemingly simple mission, when compared with trying to bring lay people up to speed on the factors and consequences of "services distribution and utilization variations...and outcomes," this does not mean it is easy. When we called, Dr. Gawande was in the Middle East, just one more leg of a global trek to promote his WHO surgical safety checklist to as many hospitals and clinics as he can. Like Wasson's innovation, Gawande's is less about new matter than it is about new method. Error comes from inconsistency, as he wrote, "a simple step forgotten" can cause death. So the surgeon and staff at HSPH produced a rules-set for routine. Its particular purpose aside, this is a model innovation for many reasons: it is discrete, requiring no supporting technology and has no shelf life (washing your hands will always be safer); it is easy to use; easy to replicate; and free. Distribution = Xerox. Would that all change in healthcare were so

straightforward.

20. Dr Devi Shetty - Founder of Narayana Hrudayalaya health system

An Indian philanthropist and a cardiac surgeon who founded the Narayana Hrudayalaya health city concept which means 'One-point for all Healthcare needs.


The Health City intends to cater to about 15,000 outpatients every day and charges people according to what they can afford.Along with the world’s largest heart hospital with 1000 beds performing over 30 major heart surgeries a day, a full-fledged 1400-bedded Multi Specialty hospital that handles Neurosurgery, Neurology, Paediatric, Nephrology, Urology, Gynaecology, Gastroenterology, ENT cases amongst various others. Despite helping so many poor patients, it is known for being so efficient, that it has a higher profit margin (7.7% after tax) than most American Private Hospitals (6.9%). It is building large hospitals across India totaling 30,000 beds, to enable it to gain large economies of scale and bargain down the cost of supplies to the hospitals.The telemedicine service, which is offered free, was started in the hospital in the year 2002 to cater mainly to the rural populace in the country. The telemedicine network of the hospital connects to countries like Malaysia, Mauritius and Pakistan; with most of the cases referred through telemedicine being cardiac ones.

21. Herbert Boyer – Co-founder of Genentech, Inc

Also a director of Genentech from 1976 to 2009 when Genentech was acquired by the Roche Group. He served as Vice President of Genentech from 1976 through his retirement in 1991. Dr. Boyer, a Professor of Biochemistry at the University of California at San Francisco from 1976 to 1991, demonstrated the usefulness of recombinant DNA technology to produce medicines economically, which laid the groundwork for Genentech’s development. In 2007, Dr. Boyer was awarded the Perkin Medal by the Society of Chemical Industry for his contributions to recombinant DNA technology. Dr. Boyer received the 1993 Helmut Horten Research Award for his research in the use of gene technology in medicine. He also received the National Medal of Science from President George H. W. Bush in 1990, the National Medal of Technology in 1989 and the Albert Lasker Basic Medical Research Award in 1980 for his development of recombinant DNA technology. He is an elected member of the National Academy of Sciences, a Fellow in the American Academy of Arts & Sciences and a former Trustee of The Scripps Research Institute.

22. Jim Yong Kim MD – Most Recently President of Dartmouth College

Jim Yong Kim, along with Paul Farmer, Todd McCormack, Thomas J. White and Ophelia Dahl, co-founded Partners In Health (PIH) in 1987. The organization began with radical new, community-focused health care programs in Haiti, which executed treatments based on local needs and by training community members to implement them. It achieved remarkable success treating infectious diseases at low cost, spending $150 to $200 to cure tuberculosis patients in their homes, treatment that would have cost $15,000 to $20,000 in a U.S. hospital. Kim was instrumental in designing treatment protocols and cutting deals for cheaper, more effective drugs. The PIH model was expanded and by 1998, extremely successful results curing both common and serious ailments prompted the World Health Organization to embrace the model and the efforts to treat multi drug resistant TB have now been replicated in more than 40 countries around the world. Kim Joined the WHO in 2003 and in March 2004, he was appointed as director of WHO’s HIV/AIDS department, Dr. Kim oversaw all of WHO’s work related to HIV/AIDS, focusing on initiatives to help developing countries scale up their treatment, prevention, and care programs. Kim began the WHO program that has treated 7 million Africans with HIV. In recent years, Kim spearheaded the development of a new field focused on improving the implementation and delivery of health interventions in poor communities around the world. His programs operate with the philosophy that progress in developing more effective global health programs has been hindered by the paucity of large-scale systematic approaches to improving program design.

23. Rebecca Onie – co-founder and CEO of Health Leads


In 1996, during her sophomore year at Harvard College, Rebecca Onie founded Health Leads (formerly Project HEALTH) with Dr. Barry Zuckerman, Chair of Pediatrics at Boston Medical Center. As Executive Director of Health Leads, Rebecca oversaw the organization's growth to Providence and New York City. Health Leads mobilizes college volunteers to connect patients and their families with the basic resources they need to be healthy. With Health Leads, doctors can “prescribe” resources such as food, housing and heating assistance – just as they do medication. Patients take their prescriptions to the clinic waiting room, where volunteers help “fill” them by connecting patients to community services. Most recently, she was named to Forbes Magazine’s Impact 30, recognizing the world’s top 30 social entrepreneurs. Rebecca is a World Economic Forum Young Global Leader, U.S. Ashoka Fellow, and member of the Young Presidents’ Organization and the Mayo Clinic Center for Innovation External Advisory Council. She has received the John F. Kennedy New Frontier Award; the Jane Rainie Opel ’50 Young Alumna Award; and the Do Something Brick Award for Community Leadership.

24. Goran Henriks – CE Learning and innovation, Qulturum

Göran is CEO of Learning and Innovation at the Qulturum in the County Council of Jönköping, Sweden. The Qulturum is a centre for quality, leadership and management development for the employees in the County and also for the health care on the regional and national level. Göran took up his appointment in the start of Qulturum 1998. He has over twenty year’s experience of management in the Swedish health care system and is a member of the Jönköping County Council Strategic Group. Göran has been Jönköping’s project director for the Pursuing Perfection initiative over the last four years. He is a senior fellow of the Institute for Healthcare Improvement, Cambridge, MA and part of the Strategic Committee of the International Quality Forum organised by the British Medical Journal (BMJ) and the Institute for Healthcare Improvement.


Innovation Strategists: individuals who have made a successful career of studying innovation 25. Clayton Christensen - Harvard Business School

Harvard Business School Professor Clayton Christensen is the architect of and the world’s foremost authority on disruptive innovation. Clay was named the World’s Most Influential Business Management Thinker in 2011.

26. Rosabeth Kanter - Harvard Business School

Rosabeth holds the Ernest L. Arbuckle Professorship at Harvard Business School, where she specializes in strategy, innovation, and leadership for change. Her strategic and practical insights have guided leaders of large and small organizations worldwide for over 25 years, through teaching, writing, and direct consultation to major corporations and governments. The former Editor of Harvard Business Review (1989-1992), Professor Kanter has been repeatedly named to lists of the "50 most powerful women in the world" (Times of London), and the "50 most influential business thinkers in the world" (Accenture and Thinkers 50 research). In 2001, she received the Academy of Management's Distinguished Career Award for her scholarly contributions to management knowledge; and in 2002 was named "Intelligent Community Visionary of the Year" by the World Teleport Association, and in 2010 received the International Leadership Award from the Association of Leadership Professionals.

27. Prof Henry Chesbrough - Haas business school, Berkley.

Henry Chesbrough coined the term open innovation and is the author of Open Innovation: The New Imperative for Creating and Profiting from Technology (HBS Press, 2003). He has also written two other books on open innovation: Open Business Models: How to Thrive in the New Innovation Landscape (HBS Press, 2006) and Open Innovation: Researching a New Paradigm (Oxford, 2006), an edited book of academic papers. Chesbrough is currently an adjunct professor and the executive director of the Center for Open Innovation at the Haas School of Business at the University of California, Berkeley. The Berkeley Innovation Forum is a membership organization hosted by Dr.2 Henry Chesbrough and the Program in Open Innovation. In brief, the Berkeley Innovation Forum is a community of innovation leaders that meet to exchange ideas, issues, and practices in innovation management, and to fund research of interest to the group. Through an environment of non-competing companies, BIF members explore new ways to advance the management of innovation by engaging openly with one another.

28. Professor Howard Rush, Innovation Management, University Brighton

Howard has worked in science and technology policy since 1974. Originally trained as a social psychologist with degrees he completed his PhD by publication in the field of Innovation Management at the University of Brighton. A founder member of CENTRIM (CENTre of Research for Innovation Management) he has also been Head of Research Development for the Business School. Howard was awarded a Professorship in 1996. As a researcher and research manager at CENTRIM he has lead work on the socio-economic impacts of information technology, benchmarking of research and technology institutes, the diffusion of new technologies in developing countries, the evaluation of government policies and regional innovation policy. Between 1996 and 2006 he was co-director of the ESRC-funded Complex Product Systems Innovation Centre. Howard has been a visiting fellow at the Institute of Industrial Economics in Rio de Janeiro in Brazil and 'Innovator in Residence' at the University of Queenland's Business School, Brisbane, Australia. He has been the


Chair of NATO's funding review panel on Science and Technology Policy, a member of the EPSRC's Peer College and the ESRC's Director's Network, as well as an expert advisor to the OECD and the European Commission. Howard has also conducted research and consultancies for many governmental organizations such the UK Government Department for Business, Enterprise and Regulatory Reform (BERR) and its predecessor the DTI (Department of Trade and Industry), The World Bank, and United Nations agencies such as the ILO, UNEP, UNESCO, and IFAD.He has been one of the leading proponents of CENTRIM's 'closing the loop' approach to industry/academia relations and has been a supervisor on the Knowledge Transfer Partnership programme and has recently received his full certification to run CENTRIM's new programme on Managing Innovation


Social Media Innovators: use the power of the internet to

enable the public to contribute to and drive change and

improvement

29. Pete Cashmore – Mashable

Founder and CEO of Mashable, an award-winning site and one of the largest and most popular destinations for digital, social media, and technology news and information with more than 20 million unique visitors per month. Mashable has been named a must-read site by both Fast Company and PC Magazine and is ranked as the most influential media outlet by Klout. Pete founded Mashable in 2005 as a blog focused on up-to-the-minute news on social networks and digital trends. Since then, Mashable quickly grew to be one of the top 10 and most profitable blogs in the world. Pete was named one of Ad Age’s 2011 influencers, a Time Magazine 100 in 2010, and a Forbes magazine web celeb 25. He was also named a Briton of the year by the Telegraph in 2010. Pete is a World Economic Forum 2011 Young Global Leader.

30. Todd Park, Chief Technology Officer, US Government

Todd Park is the United States Chief Technology Officer and in this role serves as an Assistant to the President. Todd joined the Administration in August 2009 as Chief Technology Officer of the U.S. Department of Health and Human Services (HHS). In this role, he served as a change agent and “entrepreneur-in-residence,” helping HHS harness the power of data, technology, and innovation to improve the health of the nation. He led the successful execution of an array of breakthrough initiatives, including the creation of HealthCare.gov, the first website to provide consumers with a comprehensive inventory of public and private health insurance plans available across the Nation by zip code in a single, easy-to-use tool. Prior to joining HHS, Mr. Park co-founded Athenahealth and co-led its development into one of the most innovative health IT companies in the industry. He also co-founded Castlight, a web-based health care shopping service for consumers. Mr. Park has also served in a volunteer capacity as a Senior Fellow at the Center for American Progress, where he focused on health IT and health reform policy, and as senior health care advisor to Ashoka, a leading global incubator of social entrepreneurs, where he helped start Healthpoint Services, a venture to bring affordable telehealth, drugs, diagnostics, and clean water to rural India. Mr. Park graduated magna cum laude and Phi Beta Kappa from Harvard College with an A.B. in economics.

31. Michael McNally - Brand Relations Director, LEGO

LEGO CLICK is an online community that brings together innovators, designers, artists and creative thinkers to develop new ideas. The site is designed to bring together ideas in written form, images and videos. They want to capture and catalogue ‘lightbulb moments’, ideas that are relevant to the market LEGO serves.

32. Bertelan Mesko – Webicina

Webicina.com is the world’s first and only free service that provides curated medical social media resources in over 80 medical topics in over 17 languages. Our mission is to let empowered patients and medical professionals access the most relevant social media content in their own languages on a customizable, easy-to-use platform for FREE. Dr. Bertalan Meskó graduated from the University of Debrecen, Medical School and Health Science Center in 2009; he is now doing PhD in clinical genomics. He has been running the multiple award-winning medical blog, Scienceroll, since November, 2007, and had over 4 million hits. He thinks medical education and communication between physicians and patients will be revolutionized with the tools


and services of social media. He is a medical blogger, a microblogger, a manager of medical projects in Wikipedia and an organizer of scientific events in Second Life. He launched the first university elective course in the world that focuses on web 2.0 and medicine for medical students. He was included in the Healthspottr Future Health 100 List and presented Webicina at the New York Stock Exchange in 2011 as a member of the Kairos Society. He thinks medical professionals of the 21st century have to be ready to meet the expectations of e-patients and e-patients will change the way medicine is practiced and healthcare is delivered.


Investors in Innovation: individuals who have a track record of investing in succesful healthcare ventures and bringing innovative ideas to the marketplance.

33. Nina Nashif, MD Health Box

Managing Director at Sandbox Industries, a start-up foundry and early-stage venture capital firm, where she leads new business development and strategic initiatives. She is also the Founder of Healthbox, a business platform created to stimulate global innovation and entrepreneurship in the health care industry. Healthbox is one of the first of its kind focused exclusively on the healthcare industry. Nina is best known for her expertise in creating entrepreneurial ventures and leading high performing teams to achieve results. Her background includes more than ten years of global business experience within very different organizational settings. Prior to joining Sandbox, she was on the executive leadership team of Sg2, a private healthcare analytics and consulting firm, where she founded and led the international division based in London, England. While at Sg2, she worked with both the public and private health care sectors in more than ten countries around the world, including the United Kingdom, United Arab Emirates, Thailand, Singapore, Hong Kong and Australia. Her professional experience also includes tenure as a consultant to the leadership team of the Health Authority Abu Dhabi, Director of Market Development in the International Services Division of The Methodist Hospital in Houston, Texas and Co-Founder of a Turkish cotton textile business in New York/Istanbul.Nina is a well-known thought leader and very passionate about stimulating innovation in the healthcare industry and supporting entrepreneurship across sectors. She is a frequent speaker on these topics at conferences and events around the world. She is also a member of the International Women’s Forum, on the Life Sciences Advisory Board of Springboard and involved in local civic organizations that support education, women and children.

34. Barbara Lubash Co-founder & Managing Director Versant Ventures

Barbara Lubash specializes in healthcare services and information technology at Versant. In her career as an operating executive and venture capital investor, Barbara has led and advised provider, payer, and healthcare IT organizations throughout the US. Prior to co-founding Versant Ventures, she was a Partner at CrossPoint Venture Partners. Barbara was formerly a division President at PacifiCare Health Systems, and was Senior VP at PHCS, a national PPO. Her operating career also includes management roles at the hospital information systems division of Hewlett Packard and the Harvard Community Health Plan, where she managed one of the first U.S. electronic medical records installations. Versant Ventures is a leading venture capital firm that specializes in investments in game changing medical devices, biopharmaceuticals, and other life science opportunities. Founded in 1999, the firm consists of an experienced team of managing directors committed to helping entrepreneurs build successful companies that impact healthcare and improve quality of life. Their focus is medical devices, biopharmaceuticals, and other life sciences opportunities.

35. Phillip Colligan Exec. Director Public Services lab and Innovation, Nesta Philip Colligan is the Executive Director of Nesta’s Innovation Lab, which is working with innovators in public services, civil society and business to develop radical new responses to some of the most pressing social and economic challenges. Philip joined Nesta in May 2010 and has built a portfolio of high impact programmes supporting innovations across public services, healthcare, neighbourhoods, digital technologies, volunteering and philanthropy, and support and finance to social ventures. He is also responsible for overseeing the development of Nesta's


Innovation Skills strategy. He regularly advises government, public service organisations and charities on innovation strategies and capabilities, both in the UK and internationally. Philip sits on a number of advisory and funding bodies, including the Board of the Centre for London at Demos and the Advisory Committee of Big Society Capital. He provides support and advice to numerous social entrepreneurs and is a non-executive director of Stepping Out, a social business supporting public services to spin out.

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