MedTech Innovation
for Wales
In September 2024, the Learned Society of Wales and Health Technology Wales convened a group of experts from academia, NHS, industry, and government, to discuss innovation in medical technologies for the benefit of Wales.
Wales wants to innovate: this brief report details the conditions required for a dynamic and potent MedTech innovation ecosystem that will allow this innovation to develop, bringing health and social care benefits, value for money, and economic growth for Wales.
Systems
FAIL FAST
Failure is an inevitable and useful part of the innovation process: an 80% failure rate is considered positive. This clashes with the systems and processes of a traditional, risk-averse public sector. Moreover, without reassurance that a proportion of failures, and learning therefrom, is an acceptable part of the innovation process, staff often revert to old, inefficient ways of working. A modern health service needs systems and processes that build in failure as part of the innovation process, managing and accounting for it rather than punishing it.
The “fail fast” model minimises disruption by identifying failure early, with smooth routes for moving on. This method should in turn free up time to give sufficient time for innovations with a higher likelihood of success to develop.
A FRONT DOOR FOR INNOVATION
Innovative clinicians and researchers need to know where to bring a good idea at the early stage. A clear “front door” for innovation would signpost resources, opportunities, risks, and next steps:
- Signpost key organisations and people involved in innovation.
- Provide links to key existing reports, research and strategies that will enable people to access information quickly.
- Learn from and link with innovation hubs, industry and health services across the UK and internationally.
- Signposting for clinical trials and key stakeholders, especially for researchers outside of medical schools.
- A central hub to streamline the repetitive bureaucracy behind data sharing and partnership agreements.
- Centralised resources to support appropriate economic analysis to facilitate smooth collaboration with industry.
- Facilitate connection and collaboration with industry in a bi-directional way.
- Allow for strategic needs-based planning and coordination of research.
It takes time for researchers to learn what the sector needs from Health Technologies. A front door for innovation could offer a single place for this information, allowing up-and-coming researchers to more efficiently turn their attention to where the need is. Similarly, University Health Boards could make the most of their university links by directing students to current challenges for their degree projects.
"A modern health service needs systems and processes that build in failure as part of the innovation process, managing and accounting for it rather than punishing it."
LONG-TERM JOINED-UP FUNDING
Projects need longevity in order to develop fully. Piecemeal small grants create breadth but not depth, often causing great ideas to wane at crucial stages. Longer-term funding is also crucial for retaining talent. Long-term funding partnerships with industry can facilitate agility of response, and build relationships and trust.
Shared national capabilities – instead of small resources replicated across institutions – can create efficiency gains as well as more ambitious and competitive innovation.
As a small country, Wales can’t excel at everything, but has opportunities within MedTech innovation to leverage its size and demographics in undertaking translational clinical research initiatives. Our strengths in semiconductors and media are a model for success. Strategic prioritisation in MedTech innovation would create a critical mass, and economies of scale. This will provide the ability to build on the proven success of a number of key innovations that have been demonstrably impactful in previous years.
Carmarthenshire’s TriTech Institute offers an alternative model for funding, which could be replicated for certain areas of innovation. The research and development institute is funded by the Hywel Dda University Health Board, on a successful cost recovery basis.
The Bevan Exemplars is another established initiative in Wales, encouraging early-career health and care professionals with great ideas to develop innovative projects. Going forward, successful innovations emerging from this programme need appropriate support for follow-through and translation into commercialisation.
INNOVATION-WISE GOVERNANCE
Governance systems that are knowledgeable about innovation support efficient working across the health service. Increased familiarity with the details of health service legislation would increase confidence and lower unnecessary barriers surrounding risks and new approaches.
Streamlined governance at the assessment stage supports clinicians to feel confident that an intervention is safe, thereby facilitating crucial data collection. A dedicated advisory group could offer significant benefits by coordinating and streamlining research governance issues surrounding data sharing agreements, access to shared infrastructure, and ethical approval.
Culture & Talent
Alongside functioning systems and processes suited to modern innovation, a successful innovation nation requires a culture of enthusiasm, positivity, collaboration, community and cohesiveness, for an ecosystem that is greater than the sum of its parts. This approach has benefits for all parts of the system: efficiencies and cost-savings for the NHS; greater impacts for academics to report to the Research Excellence Framework; and more profit for Welsh industry.
JOB SECURITY FOSTERS INNOVATION
Most early-career researchers in the UK are on fixed-term contracts, often under a year, and often part-time. Short-term grant funding is part of the reason behind these unattractive contracts for early-career researchers, who often find better opportunities in industry or abroad.
Moreover, opportunities to collaborate quickly with industry is frequently stymied by slow recruitment. Early-career researchers with permanent contracts are able to work across multiple projects, and can start work straight away when opportunities arise. A critical mass of research capacity immediately to hand allows research teams to collaborate with industry on a more agile basis.
Early-career researchers report that chasing short-term contracts results in disjointed and uncompetitive career paths. By working with whoever will hire them when their contract is coming to an end, rather than making deliberate career moves, they struggle to develop the deep expertise that makes a strong candidate for external funding.
Short-term contracts also exacerbate inequities and lack of diversity in the research sector, because individuals with generational wealth and without caring responsibilities are more likely to be resilient to periods of unemployment. Meanwhile, studies show that diversity improves science.
TIME TO INNOVATE
The insights and ideas of clinicians are crucial for research and development. Time for innovation needs to be protected through inclusion in job descriptions, key performance indicators and objectives. Long-term research fellowships can help to bridge this gap and shoulder some of the burden for clinicians.
Researchers and clinicians report that the health service can be more open to ideas generated by external organisations than internally, which creates inefficiencies. Wales benefits most when it recognises its own talent, for example by supporting initiatives emerging from the Bevan Exemplar programme.
Encouragement is also important for emerging innovators. A structured route for individuals who have had success in innovation to become mentors would help new innovators to save time by sidestepping avoidable pitfalls, and to be inspired by relatable role models who have navigated the Welsh context. Encouragement can also come in the form of recognition: an annual celebratory event featuring prizes and opportunities to win pump-prime funding would attract the attention of emerging researchers and innovators, galvanising efforts towards current challenges and platforming role models to inspire the next generation.
"A successful innovation nation requires a culture of enthusiasm, positivity, collaboration, community and cohesiveness."
INDUSTRY LITERACY
In order to facilitate strong partnerships with industry, and to avoid reinventing the wheel, academics and clinicians need to develop good knowledge of how industry operates. For example:
- Larger companies are often international, so decision-makers might be remote.
- Industry works in fiscal years; academia in academic years.
- Industry is generally faster-paced than academia; small and medium-sized enterprises and start-ups work on particularly tight timescales.
- Intellectual property sharing agreements are a key part of the process for industry partners.
Academics can offer valuable help to industry partners, for example:
- networking
- links with clinicians and other experts
- signposting and accessing funding
This support needs to be recognised and rewarded appropriately, rather than offered on an ad-hoc basis.
BUILDING TRUST
Staff and patient attitudes have a significant impact on adoption.
- Communication: The positive impacts of every innovation needs to be communicated fully and carefully.
- Training: Clinicians need time to train and use new technologies in order to feel confident that it works in their specific context.
- Technical support: At the early stages of adoption, clinicians need reassurance of support from technicians or engineers if something goes wrong with new technology.
Lack of trust can result in public sector duplication, investing in both the old and the new technologies, which results in inefficiencies and additional costs.
About Health Technology Wales
Health Technology Wales (HTW) is a national body working to improve the quality of care in Wales. We collaborate with partners across health, social care and the technology sectors to ensure an all-Wales approach. We are funded by Welsh Government and hosted within NHS Wales, but independent of both.
Our remit covers any technology or model of care and support in health and social care that isn’t a medicine. For health, this could include medical devices, diagnostics, procedures and psychological therapies. For social care, this could include equipment, or different models for supporting families, children, adults and the workforce.
About the Learned Society of Wales
LSW is Wales’ National Academy for Sciences, Arts and Humanities. We believe in the advancement of knowledge, and the power of research and innovation to benefit Wales’ economy and society.
National Academies are an route for experts to support independent, evidence-based policymaking, on key issues such as climate change, health, and the economy. We represent Wales in the international science and research community, positioning Wales as a knowledge economy that values evidence-based decision-making.
LSW’s Fellows are Wales’s foremost experts across all areas of knowledge. Elected on the basis of excellence, their multidisciplinary expertise, experience, and connections are an invaluable resource and asset for Wales.