Driving sustainable innovation at scale in health systems

Health systems today face a difficult balance: delivering better care with fewer resources, while also driving forward innovation that is meaningful and lasting.

As part of the Health Foundation’s Accelerating Innovation Systems programme, a team led by Dr John Byrne, Director of Innovation & Research at NHS South West London Integrated Care Board (SWL ICB) and colleagues, alongside the Health Innovation Network South London (HIN) recently had the privilege of visiting IBM in their Innovation Studio. This visit aimed to explore how innovation can become a more integrated, strategic function, rather than something that lives on the margins.

IBM do not set out to try and provide all the answers to the many questions and challenges related to innovation themselves. Rather, they aim to be a trusted partner, bringing cross-sector insight, practical frameworks, and a collaborative approach to help health systems test, scale, and sustain innovation in ways that are appropriate to their context.

Embedding Innovation as a System Capability

The day  focused on a key challenge: how to move beyond isolated pilots and embed innovation more deeply into the day-to-day fabric of health and care systems. This is always a challenge in the NHS, where the current focus is on adoption and scaling of proven innovations so more patients benefit. Some of the key areas we explored included:

1. Innovation as a cultural operating model

Rather than viewing innovation as a separate function, we looked at how health systems can make it part of their cultural infrastructure.

We examined how large, regulated organisations embed innovation as a continuous process, supported by:

• Leadership commitment and cultural alignment;
• Upskilling and capability-building across teams;
• New ways of working that encourage experimentation and rapid feedback loops.
  
  

For health systems, this means fostering a mindset where innovation is everyone’s responsibility, not just the remit of a single team.

2. Moving from pilots to scaled impact

Too often, promising pilots stall before reaching scale. We explored barriers such as short-term funding cycles, siloed infrastructure, and unclear adoption pathways and discussed what it takes to move from experimentation to sustained change.

Key enablers include:

• Enterprise architecture alignment: ensuring innovations fit within broader system design;
• Flexible platforms: avoiding isolated point solutions in favour of interoperable, scalable technologies;
• Built-in adoption pathways: co-designing with end users and stakeholders from the outset.
  
  

For the NHS, this means cultivating the right culture, capabilities, and partnerships alongside robust co-production practices to ensure innovations are not only tested but embedded.

In practice: transforming patient engagement at one of the UK’s largest NHS trusts

Faced with outdated systems and a reliance on manual processes, a major NHS trust partnered with IBM to modernise its patient engagement channels. The goal: improve patient experience and reduce administrative burden.

Using IBM Garage, Celonis process mining, and advanced data analytics, over 500,000 pseudonymised patient journeys were analysed. This rapid, equity-focused approach uncovered actionable insights in weeks. IBM watsonx.ai was also piloted to support backlog management by reading clinical letters and verifying waiting list statuses using GenAI.

The impact?

• Over 700 more patients seen weekly without increasing staff;
• Up to 15% reduction in backlog;
• DNA rates dropped from 10% to 4% with smarter SMS reminders;
• AI reviewed clinic letters in 18 hours versus 4 years for manual review.
  
  

This collaboration showcases how data-driven innovation can deliver meaningful improvements in NHS outpatient care.

3. Using data and AI to identify where to innovate

With resources under pressure and ICBs evolving as strategic commissioners, it’s vital to focus innovation where it delivers the greatest impact. We explored how data and AI can help identify these opportunities.

Examples included:

• Process mining: uncovering inefficiencies, variation, and redesign opportunities across care pathways;
• Digital twins: simulating system changes before committing to large-scale implementation;
• Outcome-driven AI investment: prioritising use cases like reducing missed appointments, enabling intelligent triage, and improving population health management.
  
  

These tools offer a way to shift from reactive problem-solving to proactive system design aligned with the NHS’s long-term priorities of prevention, community-based care, and digital transformation.

4. Scaling innovation in resource-constrained settings

Drawing lessons from sectors like finance, logistics, and telecoms, we explored how large organisations scale automation and AI even in constrained environments.

IBM shared examples of:

• Ambient documentation: reducing clinician burden through voice-enabled note-taking;
• Predictive rostering: optimising workforce planning using AI;
• Smart referrals: streamlining patient pathways with intelligent triage.
  
  

We also discussed the importance of ethical governance, ensuring AI deployment in public health systems is transparent, equitable, and accountable.

5. Building sustainable innovation ecosystems

Finally, we explored the NHS not just as a provider, but as a platform for innovation; one that enables collaboration across academia, startups, and industry.

We looked at what it takes to build an “innovation supply chain,” including:

• Open data and APIs to foster interoperability;
• Sandboxes for safe experimentation;
• Procurement models that support co-development and shared risk.
  
  

This ecosystem approach is essential for unlocking the full potential of innovation especially in a system as complex and interdependent as the NHS.

Closing reflections

Innovation in health systems isn’t just about new technology, it is about creating the conditions for ongoing change, even in challenging times. The collaboration between IBM, SWL ICB, and the HIN was a valuable opportunity to reflect, learn, and co-create new approaches to sustainable innovation.

If you're exploring similar challenges or simply want a space to think out loud about embedding innovation more deeply – please do get in touch with us.

Want to dive deeper into the concepts discussed here?

Check out IBM SkillsBuild for free resources on design thinking, agile innovation, and other practical tools to help build innovation capability across your organisation.