If AHSNs are failing can we at last have a democratic space for innovation in the NHS?

Today I have been in Bolton to kick-off the NHS North West R&D Conference. 170 delegates – including patients and the public – getting together over two days to talk research. A great event and I hope they feel I got them off to a good start with my talk.

It occurred to me afterwards that I have yet to be invited to attend an event hosted by one of the 15 Academic Health Science Networks (AHSNs). These are the bodies supposedly set up to bring local and regional partners together to drive innovation in the NHS.

So where are they? No, really, I mean, where are they?

Any time I visit a place I ask what’s happening with their AHSN. Almost without exception it triggers much shrugging of the shoulders and the sort of nervous chatter that only Scoop out of ‘Bob the Builder’ can better. I can certainly tell you from
a public involvement point of view they have barely made a mark.

Are we to presume they are a failure or, at the very least, failing?

Poorly conceived, their role badly defined, working to a short-term agenda and often without focus or leadership. The results seem more variable so far than a bunch of scones made by an early evictee from British Bake-Off.

When I hear what’s happening in local public involvement, I think we can be forgiven for feeling a sense of injustice that such pet initiatives would appear to get an easy ride. If only, if only….

In February last year I wrote that AHSNs might be an opportunity to shift the consensus around the innovation agenda. In fact I thought that was part of their role! But the only shifting I can see is bottoms on seats.

So if they are failing, can we at last have something truly
innovative: an independently governed democratic space in each region where innovations can be co-produced and co-diffused?

15 ‘innovatoriums’ run as social enterprises and in the public interest. Where there is equity of access, equality between the partners and a mutual sharing of the benefits.

Fanciful? Perhaps. But given what’s happening with the AHSN
experiment, what have we got to lose?

4 thoughts on “If AHSNs are failing can we at last have a democratic space for innovation in the NHS?

  1. Dear Simon,
    Always more noticeable to make a bunch of evidence free anecdotal assertions than to be accurate, but I don’t think you are right about the AHSNs. Running one I am obviously biased, but if you look at the fifteen across the country they are doing a great deal of varied and worthwhile projects. Of particular note are initiatives from all of us in the roll out of Patient Safety Collaboratives post Francis and Berwick. In South London at the Health Innovation Network we are building on the principles of the successful networked transformation of the capital’s stroke care in 08-10 to work on diabetes, dementia, cancer, alcohol and OA. Our work on patient education in diabetes and on a carer/patient held record in diabetes is particularly noteworthy. I’m confident all 14 of my colleagues could tell similar stories, and have attracted senior NHS leaders into the MD/CEO roles. UCLP, with ahead start are even further down the delivery line than others, and would quote novel oral anticoagulants and progress on cancer and cardiac care amongst a set of achievements.
    Anyway, without myself falling into the assertion trap I will stop there, but my challenge back would be to visit any one of us and get us to show you what we are up to first hand, and then be in a position to make constructive comment.
    Best wishes
    Chris Streather MD HIN (South London AHSN)

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    1. Hi Chris,
      Delighted to post your comment.
      I wouldn’t deny that I was being deliberately provocative and perhaps unreasonably so.
      Nor would I want to decry the excellent work that you and others are doing and have rightly pointed too.
      But, as ever, for me one of the questions I would have is ‘by whose measure?’ The established scientific interests on your patch. Or those of a broader range of partners including patients and the public.
      And it is that last partner that I am most interested in trying to reflect in terms of my blog.
      It is great that there is now an AHSNs PPI group. But I do not see enough evidence of public involvement in the work that you are all doing to both set priorities and shape the work. From
      Board level downwards.
      Only last night I checked on your website and clicked on the link for ‘patients’ under ‘about us’ and there is a blank page. http://www.hin-southlondon.org/about/our-people/patient-representatives
      That might seem petty but these sorts of things concern me. And my blog was as much about how AHSNs are not good at saying what they are doing as doubts I have about how far they are really pursuing public involvement.
      I am sure you will be pleased to know that I have had lots of emails and invitations since my post and I intend to take them all up.
      After which I will do another blog I promise. Whether you will like it more remains to be seen.
      Thanks again.
      Simon

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      1. Thanks Simon,
        Sounds like we have our communications wrong. Both pragmatically and philosophically we have patient engagement at all levels in the HIN. On the board, at our member ship council, but more importantly in every programme right down to individual project level. This both works and is the right thing to do. We have run events on co-creation, virtually never run an outward facing event without a patient or carer on the platform and the two initiatives I have talked about earlier, education in diabetes and MyBrainBook in dementia have been designed with patients and the third sector from the beginning. We also work with Patient opinion to try and listen to feedback att greater speed and accuracy. Again open to anyone coming and having a look to see if words match deeds, very sorry about web omissions, will put them right!

        Best wishes

        Chris

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