NHS culture holds back innovation and I want to change it, says Yorkshire Academic Health Science Network chief executive Richard Stubbs

Since then that loaded adjective has become something of a millstone around the Prime Minister's neck as the much-vaunted system struggles to reach the numbers of people needed to contain the pandemic.

But, as Richard Stubbs tells The Yorkshire Post, in less high-profile areas of the NHS around the region and further afield, "literally world-class excellence" can be found wherever you look.

And his job, as the chief executive of the Yorkshire and the Humber Academic Health Science Network, is to identify the areas of cutting-edge innovation and world-class excellence on his patch and work out how to replicate it across the service.

"Different parts of the NHS excel in different ways and my job is to know what all those pockets of excellence are and say 'this should be happening everywhere'.

"This is a universal system, tax-funded. If our patients in Dewsbury have a world class diabetes service, I want the patients in Rotherham to have the same."

The process of change, he admits, has historically been rather sluggish in the NHS, with an average lead-in time of 17 years for an innovative practice to fully enter the mainstream.

As someone who has spent much of the last ten years trying to bring that gap down, Mr Stubbs says it largely comes down to culture.

"It's around the fact that actually, it isn't a single NHS, we are 400 to 500 separate organisations and there is a culture of 'it's different here because', that comes up time and time again," he says.

"We can talk about some of the other problems such as financial disincentives. So, for example, if you have a fantastic innovation in an acute hospital which is quite expensive, but the savings of using that innovation are going to be felt in the community, or primary care sector, there are very few incentives currently to make that kind of investment.

"So a lot of this is about trying to find a win-win, the finance, culture, sometimes even just the absolute intensity of doing the job means NHS staff have little headroom to step back and think 'how can we do this better?'.

"Most of our time is spent just at the coalface, absolutely 'patients, patients, patients', which is the resource we've got at the moment. But for me it's culture and that's why it's largely a challenge of how do you get people in the NHS, very senior autonomous professionals, to want to take other people's work, and bring it in and embed it."

Currently living in Sheffield, the 44-year-old was brought up in the former mining town of Maltby, the son of a Jamaican nurse and a white South Yorkshire miner.

The first in his family not to go down the pit after four generations, he started his career at the BBC in Manchester before entering the NHS in 2002 as a graduate management trainee.

Taking on his first national role at the NHS Institute for Innovation and Improvement in 2010, he started work at the AHSN in 2014 and took over as chief executive in June 2016.

"I always say, half in jest, that the thing I love about the job most is I get to live in the future," he says.

"Because actually, I'm not a technologist, I'm not a scientist, I'm not a clinician, but I get to work with really cutting-edge people who are.

"And I know enough about enough to be able to just about hang on to their coattails where they're explaining about these amazing things that they are designing.

"So a lot of my time is spent hearing about the possibilities of what's out there, often in our region, you walk down the street and you uncover some amazing work happening in our region.

"And then the other bit of time is pivoting towards a service, towards the NHS, to say so how can we make this happen everywhere, and how quickly can we do it."

Asked for an example of how an innovative practice can be embedded more widely, he cites Dr Taz Aldawoud, a "fantastic GP" from Bradford.

Dr Aldawoud approached the AHSN six years ago with an idea for how city GPs could deliver care out of hours, where demands often outstrips supply and leads to long waits for patients.

His invention was an online 'app' called DocAbode, where GPs in Bradford can advertise their availability to work out of hours and are told about local patients that need their attention

"That kind of innovation, created out of Bradford, that is what really drives me, because that's something that should be happening across the country," says Mr Stubbs.

"Our job is, we've helped Taz get this far. But our next job is to make sure that it does happen across the country and there's literally thousands of Tazes, 10s of thousands of Tazes, out there."

How 90 per cent of GP appointments are now online

The pandemic has been a huge factor in accelerating changes in the NHS that had been unfolding very slowly.

The need for social distancing has sparked a technological and digital transformation where 90 per cent of patients are now seen remotely, something that would have been unthinkable a few months ago.

Mr Stubbs says: "Part of my job is to think 'how do you sustain that, how do you not make it something that's only here for a time with a pandemic but actually you take the benefit and think how can you sustain that where it's appropriate?'."

But he realises some patients still need face-to-face contact with a medic, so he hopes a system can be created where most patients can be seen quickly in a virtual setting but the more frail can be allowed much longer in front of their GP.