Dr Richard Dune

09-05-2025

Image by seventyfourimages via Envato Elements

Why embedding research and innovation into community care is key to the future of the NHS

The NHS is at a critical crossroads. A seismic shift is underway with the dissolution of NHS England, looming budget cuts for Integrated Care Boards (ICBs), and growing uncertainty around research funding. But in this moment of flux lies a rare opportunity: to rebuild a stronger, more innovative, and more equitable health and care system that places innovation at its very core.

In this blog, Dr Richard explores how earlier this year, the Wellcome Trust called for research and innovation to be recognised as the fourth essential shift in the NHS, alongside three well-known ambitions, from hospital to community, from sickness to prevention, and from analogue to digital. This fourth shift, from research to reality, is not an optional extra. It is the driving force that will determine whether the other three succeed. Without innovation, they will falter.

Breaking out of the teaching hospital model

When discussing NHS research, most imagine world-class academic hospitals like Oxford, Cambridge, or Imperial. However, healthcare today happens well beyond these prestigious walls. It occurs in GP surgeries, community clinics, care homes, pharmacies, and mobile health units parked outside local supermarkets.

If the future of healthcare lies in the community, so must its innovation. Unfortunately, the infrastructure and support needed to conduct and apply research in these settings are sorely lacking.

Primary care services outside major academic centres are often excluded from innovation funding.

Frontline staff are stretched thin, lacking time, incentives, and the digital tools required to engage in research activities.

Funding mechanisms remain heavily skewed towards hospitals, with minimal support for local trials, testing, and adaptation.

The systemic barriers to innovation

The NHS is not simply battling inertia. It's contending with significant structural headwinds:

• With NHS England now defunct, the central authority that once facilitated innovation rollout is gone.
• ICBs face real-terms funding reductions, just as they are asked to coordinate transformational change.
• The National Institute for Health and Care Research (NIHR) is experiencing funding constraints.
• Many academic health science networks are transitioning, leaving a vacuum in leadership and direction.

This is happening amid declining staff morale, reduced public confidence, and political hesitation to commit to long-term reform.

Transforming the system from the ground up

To realise Wellcome’s vision of turning research into reality, we need a series of fundamental changes in how innovation is integrated into everyday care. Here are five crucial shifts the NHS must make at the community level:

• From passive patients to empowered citizens
• From a culture of caution to one that champions experimentation
• From disconnected pilots to embedded research
• From bureaucratic roadblocks to agile innovation pathways
• From pilot projects to scaled impact.

Let’s discuss in more detail.

From passive patients to empowered citizens

Healthcare users should be co-creators in research and service development. Digital tools such as the NHS app can enable patients to share data, offer feedback, and engage in shaping services tailored to their needs.

From a culture of caution to one that champions experimentation

We need to create protected space and time for clinicians to test new ideas. This includes embedding research time into GP contracts and offering incentives for ICSs to support grassroots innovation.

From disconnected pilots to embedded research

Research should not be an afterthought or confined to academic institutions. Community-based research hubs can be powerful engines of discovery, particularly when integrated with routine health data and local service delivery.

From bureaucratic roadblocks to agile innovation pathways

Delays in ethical approvals and procurement can stifle progress. Streamlining these processes, particularly for primary care-led trials, is essential. Investing in local test beds can create faster feedback loops between research and practice.

From pilot projects to scaled impact

Funding mechanisms must support scale-up from the outset to prevent promising innovations from stalling in 'pilot purgatory'. National systems should reward adoption to ensure impactful solutions are embedded widely and quickly.

Why is the action urgent

This call to embed innovation within NHS community settings is not theoretical - it’s a practical necessity. Timely and applied research can:

• Speed up diagnosis and treatment through AI and remote monitoring
• Support personalised, preventive care closer to home
• Address long-standing health inequalities by reaching underserved populations.

In a post-NHS England era, where structural reform is ongoing, innovation must not be treated as a luxury or relegated to academic enclaves. It must become a built-in mechanism for continual improvement across the system.

The stakes are high, but so are the possibilities. If we embrace this fourth shift now, we can build a healthcare system that is resilient, responsive, and genuinely equitable.

Compliance, innovation, and readiness – A call to act

At The Mandatory Training Group, we believe innovation is inseparable from compliance. A well-governed organisation is one that learns, adapts, and improves continuously. Richard Dune has worked extensively with NHS Trusts, ICSs, care providers, and training institutions to embed compliance frameworks that enable innovation and operational excellence.

If you're looking to:

• Strengthen your compliance and digital governance frameworks
• Prepare for CQC inspections and regulatory reviews
• Integrate research and innovation into everyday care delivery.

Then it’s time to explore ComplyPlus™, our comprehensive compliance management solution designed to support inspection readiness, digital transformation, and continuous improvement.