Overcoming Barriers to Health and Care Innovation

In health and care, innovation doesn’t fail because the ideas are bad. It fails because the system isn’t built to absorb change.

Every year, we see brilliant pilots, promising technologies and passionate teams come forward with ways to improve care. Yet, so often, they stall. Not for lack of evidence. Not for lack of commitment. But because the system into which they’re trying to land is fragmented, overstretched, and riddled with structural and behavioural blockers.

At Future Care Capital, we work across evaluation, innovation management, and impact investment. And wherever we go, we see the same underlying truth:

Innovation fails when systems can’t integrate it not because it isn’t worth integrating.

So what are the real barriers? And what can be done?

Silos and fragmentation

Innovation rarely succeeds in isolation. Yet health and care services are often designed and delivered in silos. Acute. Community. Social care. Mental health. Voluntary sector. All operating on different rhythms, under different pressures, and with little shared infrastructure or incentive to join up.

As a result:

• Good ideas are hard to scale across boundaries.
• Interventions don’t transfer well between sites or sectors.
• People duplicate effort instead of collaborating.

Breaking through these silos takes more than coordination. It takes shared language, shared purpose, and shared leadership  all things we help organisations build through innovation management.

Misaligned incentives

In theory, everyone in health and care wants the same thing: better outcomes, greater efficiency, improved experience. In practice, the incentives don’t always line up.

• Providers are often funded in ways that reward activity, not outcomes.
• Commissioners may be risk-averse or tied to short-term goals.
• Frontline staff may be overstretched and wary of ‘yet another’ initiative.

In this landscape, even the best innovations can be perceived as a burden  – one more thing to do, one more risk to manage.

We believe a better approach starts with alignment. Not just between stakeholders, but between the innovation and the system it’s entering. That means clear programme logic, a roadmap to integration, and understanding where value will actually be delivered.

Lack of capacity and headspace

This is a big one.

Ask any leader or team why they haven’t adopted a promising new approach, and the answer is rarely about belief. It’s about bandwidth.

When staff are under pressure, systems are at capacity, and performance metrics dominate the landscape, there’s little room for reflective, generative work and even if it’s exactly what’s needed.

That’s why we often say: real innovation needs air. It needs protected time, psychological safety, and leadership that actively supports experimentation.

Evidence gaps and evaluation blind spots

Too often, evaluation is an afterthought. Funding ends when the pilot does. Reporting gets boiled down to a few metrics. And the very real human and systemic value of a new intervention goes unrecorded and therefore unrecognised.

When this happens, it’s not just the innovation that suffers. It’s the future potential of the system to learn and improve.

At FCC, we build evaluation into the heart of innovation. Whether it’s co-developing impact plans, building programme logic models, or conducting independent reviews, we help innovators show what works, why it matters, and how it can be scaled.

Short-term thinking in a long-term system

Innovation takes time. But funding, policy and leadership cycles often don’t.

• A 12-month pilot might need three years to show true outcomes.
• A new model of care might require long-term workforce adaptation.
• A digital tool might only prove value once it’s been integrated, refined and normalised.

If we keep evaluating long-term change on short-term timescales, we’ll keep abandoning promising ideas before they have a chance to succeed.

We need a mindset shift: from projects to pathways, from outputs to outcomes, from activity to impact.

The way forward

We don’t believe in innovation theatre. We believe in innovation that sticks because it’s been designed well, backed with evidence, and aligned with the needs of the people delivering and receiving care.

To do that, the sector must:

• Identify and name its structural blockers — loudly and clearly
• Incentivise collaboration, not competition
• Invest in evaluation and learning
• Make space for real integration
• Put people, not products, at the centre

At the end of the day, innovation isn’t about novelty. It’s about improvement for systems, for staff, and most of all, for patients and communities.