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6 principles to scale innovation from pilot to practice

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6 principles to scale innovation from pilot to practice
28th October 2025 about a 4 minute read
Mark Williams

 

The UK excels in health innovation. In 2024 the UK climbed from 15th to 11th place on the World Index of Healthcare Innovation – securing fourth place globally in Science and Technology and second in scientific discovery. London is home to more AI and data-focussed life science companies than any other city globally. 

The challenge, however, is embedding innovation into routine care pathways at scale. In UK health and care transformation, innovation adoption and diffusion (the spread of innovation through a system) are now the critical determinants of success. The NHS England Innovation Strategy notes that innovation is only valuable when it is diffused across the NHS at scale. 

Why adoption and diffusion fail 

Adoption fails when a fragmented system architecture means solutions are developed in isolation and do not align with commissioning pathways, workforce models or data infrastructure. Successful innovation adoption is, as the Health Foundation puts it, contingent on a set of system-level enablers; lack of system alignment prevents up to 80% of NHS pilots from reaching full deployment.  

Adoption and diffusion also fail when pilots are designed without a pathway to scale, resulting in limited impact despite promising results. Misaligned incentives slow decision-making and investment because innovators, providers, commissioners and regulators work to different success metrics.  

Variation across systems then compounds the problem: inconsistent digital maturity and governance across Integrated Care Systems (ICSs) leads to uneven adoption. And at the frontline, perceived risk and operational disruption increase workload and uncertainty without guaranteed benefit or support. 

Turning innovation into practice 

Innovation is the creation of a solution. Practice is when that solution is meaningfully embedded and used across the system — but the majority of innovation value is lost in the “implementation gap” between invention and adoption.  

In 2022/23 Health Innovation Networks (HINs) engaged with over 2,831 companies and supported over 1,512 innovative products, but these solutions can only generate outcomes when they are integrated into clinical workflows, supported by funding, adopted at scale, and underpinned by data and governance infrastructure. 

How to enable adoption and scale

For innovation leaders, the roadmap for success requires embedding adoption disciplines into design, delivery and decision-making from day one. FCC’s own experience shows that six key principles can bridge the implementation gap:
 

  1. Design for interoperability and system integration. Too many innovations are designed for pilots, not for systems (The King’s Fund). Ensure solutions can be embedded within commissioning pathways, clinical workflows and existing data infrastructure, rather than deployed as isolated tools.
  2. Align procurement, reimbursement and regulatory requirements early. Map routes to market, funding flows and approvals upfront to remove friction later and accelerate safe, compliant adoption. FCC’s methodologies are designed to align multiple partners around shared goals, resources and adoption timelines.
  3. Build adoption strategies alongside development. Variation in digital maturity across ICSs is the single largest barrier to scalable implementation (NHS Confederation). Plan for real-world implementation from the outset – covering change management, scale-up milestones and responsibilities – so pilots have a clear route into routine practice.
  4. Equip the workforce with digital confidence, training and change support. Provide role-specific training, protected time and on-the-ground implementation support so frontline teams can adopt new solutions without added burden.
  5. Demonstrate return on investment with real-world evidence. Evidence impact on outcomes, operational performance and cost in routine settings to secure organisational buy-in and sustained funding. FCC uses evidence from frontline programmes to shape national strategies on adoption, scale and regulation.
  6. Prioritise population need and pathway outcomes over organisational interests. Make adoption decisions against shared system objectives and pathway-level outcomes to drive consistent, scalable implementation across ICSs. 

Closing the implementation gap 

As the UK Government White Paper on Health System Reform puts it, “we must embed adoption and diffusion into the core architecture of the NHS – not treat them as optional follow-ons to innovation.”  

System adoption and diffusion are the critical levers that determine whether innovations deliver real outcomes. FCC can help – with adoption readiness frameworks, system-level implementation models, cross-sector convening, and evidence from frontline programmes to shape national policy.  

We are uniquely positioned to close the implementation gap and ensure innovation translates into practice, scale and population impact. If you’re looking to scale innovation responsibly and sustainably, contact Dr Lauren Evans at lauren@futurecarecapital.org.uk.