There is a huge range of innovations which developers hope can provide benefits to health and health services. However the NHS isa complex market and it is challenging for many developers who seek to get their innovations adopted.

To address this, innovation accelerators provide support for developers to understand how the NHS works and how to get access to this market.

Over several years, we worked with over 50 participants in an NHS-funded accelerator, across multiple annual cohorts. We a prepared short, clear economic case study for each innovation, to clarify the costs of adoption and the potential benefits in each case.

The case studies were based on available evidence of costs and benefits, rather than original research. The results used a variety of analyses, including cost-benefit and threshold analyses to indicate the potential net impact on the health and social are system and benefits for patients.

We were able to help many developers who required support in understanding the real costs of implementing innovations and the full range of benefits that could be anticipated, as well as how they can be valued.

The case studies were created with support from each participant and were provided to the accelerator for use by them and the developers themselves. Several of the case studies have formed the basis of published papers.

For patients with chronic conditions there is often a need to attend multiple hospital appointments for their monitoring and care. This represents a burden on patients and also uses a lot of healthcare resources.

For patients with heart failure (among other conditions) there is the possibility of managing their monitoring and support without the need for multiple appointments. This is partly facilitated by the availability of remote monitoring technologies, but also requires coordinated and personalised care.

A national pilot was designed by the NHS in England to assess the impacts of implementing this ‘at home’ approach. The pilot involved implementation in ten areas, with the participation of primary and secondary care providers and commissioners.

The pilot sites recorded data on three PROMs measures, to assess the impact on the experience of patents, and also on the use of health care resources to identify whether the pilot had affected patients’ need to visit primary care, outpatients, emergency and secondary care services.

The results of the pilot were reported nationally and these are being fed into plans for extending the use of remote care in heart failure as well as applying it to other conditions.

The numbers of children who survive cancer has been increasing dramatically over recent decades. The standard of care has been for these cases to be followed up for very long periods, sometimes for their lifetime.

A result of this is that the increasing number of childhood cancer survivors being followed up was putting services under strain. It was recognised that, in some cases, people could be safely discharged from follow-up after a certain period.

At the same time, many people reported a dislike for having the label of being a ´cancer survivor’ attached to them across many years.

We undertook a modelling approach for a national body in England. This involved analysing data from national sources and consulting with a wide range of professionals.

The model defined options for adopting a tiered approach, in which an appropriate level of post-treatment follow-up would be provided, according to the needs of patients. This includes their risk of recurrence and post-treatment health problems. In some cases the approach would mean discharge from follow-up.

The results of this work identified the costs of each option and made projections for the future capacity and the financial impact of such a system. This work fed into a national development programme.

One way of reducing the number of hospital visits that patients with chronic conditions have to make is the use of telemedicine.

Telemedicine and telehealth are two terms that are sometimes used without much differentiation between them. In this case the telemedicine service adopted by a health economy in England was based on enabling patients to have on-line or ‘virtual’ consultations with hospital staff.

The service was implemented for patients with confirmed COPD and it was estimated by the hospital trust that around 20% of in-person hospital admissions could be replaced by on-line consultations, with a commensurate saving in healthcare resource use.

We undertook an analysis of data on hospital activity to measure the impact of telemedicine on acute services. In addition, we used qualitative methods to identify facilitators and barriers to the use of the telemedicine services among patients.

The analysis of impact was based on a before-and-after comparison of telemedicine patients with non-telemedicine patients, as an RCT was not feasible in this context.

We reported the results for impact on hospital use and the net financial impact in a report to the client. As part of this, we also provided the client with a number of scenarios including a threshold analysis, indicating at what level use the telemedicine programme would result in a net cost reduction.

We worked with a charity that provides palliative care and receives an important part of its funding from local commissioners. It is understood that the charity’s services provide a substitute for health and social care services which otherwise would be used by these patients and their carers.

The charity was seeking to understand the value of the services it provides in economic terms and to use this to make the case for a sustained increased in statutory funding.

We first established data on the activity and cost of all the services offered by the charity in the most recent year, taking into account the impact of Covid 19.

Then we identified a categorisation of the benefits which could be attributed to the charity’s services. This was based on a search of the international published literature on palliative and end-of-life care, with a best-fit application to the charity’s services agreed with their management team.

We then built a model comparing the costs of the service to the benefits, which include reduction in health and social care service use and improvements in the quality and duration of patients’ lives. The model includes QOL benefits that apply the families and carers of palliative care patients, as well as to the patients themselves.

The results of the evaluation reported a number of analyses, including the impacts on public sector budgets and the return on investment across the health and social care economy.