Procurement in the NHS is driven by whether an innovation delivers clear value against current system priorities, and this page helps innovators identify the market fit of an innovation, what the NHS values, how those priorities shape commissioning decisions, and how to position an innovation effectively. Questions this page aims to answer include:
- What does the NHS mean by “value” when making procurement and commissioning decisions?
- How do NHS strategic priorities, including the NHS Fit for the Future: 10 Year Health Plan for England, shape which innovations are selected?
- What types of benefits are most likely to be recognised by the NHS, such as staff time savings, reduced costs, and improved patient outcomes?
- Which types of innovation value are less likely to influence commissioning decisions, and why?
- How can innovators identify which NHS priorities their innovation aligns with and evidence that fit?
- How do I identify the market fit of an innovation in the NHS care system, and who is most likely to pay to commission it?
What value does the NHS recognise?
The NHS Fit for the Future: 10 Year Health Plan for England outlines the key priorities in the NHS, but how does this impact what the NHS wants out of an innovation to fulfil its priorities? Commissioning decisions are based heavily on value to the NHS, so what does the NHS value in its current state?
Time saved for staff
The NHS is currently experiencing long waiting times and a backlog of appointments. The number of patients requiring treatment increases year on year and
places pressure on existing staff to lower the backlog. This can lead to staff working over time on their shifts or increasing their workload. In turn, staff are leaving
their jobs, meaning fewer staff are available to spread the load. Innovations that increase staff efficiency are crucial to managing backlogs and ensuring patients
can be treated within an appropriate amount of time, whilst also ensuring that staff workloads are suitable and staff wellbeing is maintained.
Reduced hospital activity
Obtaining a primary care appointment is not always accessible for some patients, particularly those who may live far away or who are unable to request an
appointment at a certain time due to other responsibilities. This can lead to deterioration of conditions, which may result in a trip to hospital.
Innovations that can help reduce the number of patients in hospitals, where treatment is typically more expensive,
are seen as desirable to the NHS. Further, preventing illness, rather than treating illness when it arises leads to better patient care.
Improved patient outcomes
Ensuring that patients receive the treatment that they require is one of the most important aims of the NHS. Advancements in technology are crucial to constantly
improve outcomes for patients. Further, ensuring that patient outcomes are consistent across demographics such as age and ethnicity are key to ensuring equitable
treatment for all patients. Innovations that reduce the impact of health inequalities and provide better care for patients are highly valuable to the NHS.
Reduced cost per patient
The number of patients requiring treatment increases year on year, meaning the NHS spends more on patient treatment overall. Finding new innovations that can
provide similar or better outcomes for patients, staff, or the system for a lower cost are favourable to the NHS. A reduction in cost per patient means that the NHS can
continue to afford patient care.
Reduced waiting times
Long waiting times for treatment in the NHS are caused by demand for care exceeding the number of available staff, beds, and funding, alongside backlogs from
the COVID-19 pandemic. Delays in treatment can lead to patient deterioration and lower patient satisfaction with care. Innovations that can reduce waiting times,
such as digital triage, AI tools, and remote monitoring can help prioritise patients and lower the number of unnecessary hospital visits.
Better access to care
High demand for appointments, as well as difficulty accessing appointments due to health inequalities at play, lead to a reduction in the number of patients being
able to access care when they need it. Ensuring that all patients are able to request and receive care to the same extent is essential to fulfil the purpose of the NHS:
to provide care for all patients. Targeted access tools or innovations that reduce the impact of health inequalities can reduce barriers to treatment.
What types of value may be less recognised by the NHS?
While the NHS places emphasis on innovations that align closely with its current strategic priorities, some types of innovation may not be as highly prioritised if they:
- Only provide improvements to technical performance
- Provide new features that do not impact on staff workflow, efficiency, or outcomes
- Are expensive to implement
- Require major changes to existing structures without clear returns
- Evidence limited effectiveness in real-world settings
How do I know which priority an innovation is solving in the NHS?
The table below illustrates how the NHS’s values in innovation align with its current priorities. Refer to the questions provided to assess how an innovation may deliver value to the NHS in accordance with the priorities outlined in the NHS Fit for the Future: 10 Year Health Plan for England.
| Innovation value to the NHS | Alignment to priorities in the NHS Fit for the Future: 10 Year Health Plan for England | Key questions to align an innovation’s value to NHS priorities |
| Increasing staff time savings | • Integrating digital technologies to replace analogue methods • Strengthen the staff workforce through increasing skills, motivation, and sustainability • Drive transformation through new innovations, such as AI technologies • Adapt NHS funding to improve productivity and financial sustainability | • Does the innovation reduce staff time spent on tasks such as paperwork or admin? • Can the innovation automate or simplify a workflow? • Will the innovation allow staff to focus more on direct patient care? • Does the innovation reduce the amount of duplication across departments or systems? |
| Reducing the number of patients being referred to hospital | • Shifting from a hospital to a community setting through the Neighbourhood Health Service • Integrating digital technologies to replace analogue methods • Moving from treating ill health to preventing ill health • Shift the NHS from a centrally driven system to a locally driven system • Drive transformation through new innovations, such as AI technologies | • Can the innovation manage patients earlier in the care pathway? Is this safe? • Does the innovation help to identify or treat a condition before a hospital referral is required? • Can the innovation support remote monitoring or at-home treatment? • Does the innovation improve decision-making to ensure that only necessary referrals are made to secondary care? |
| Improving patient outcomes | • Shifting from a hospital to a community setting through the Neighbourhood Health Service • Moving from treating ill health to preventing ill health • Increase transparency and accountability of care quality • Strengthen the staff workforce through increasing skills, motivation, and sustainability • Drive transformation through new innovations, such as AI technologies | • Does the innovation lead to faster recovery, fewer complications, or better long-term health for patients? • Is there existing evidence that the innovation improves clinical effectiveness or safety? • Does the innovation help patients manage their condition effectively? How does this compare to current solutions? |
| Reducing the cost spent per patient | • Shifting from a hospital to a community setting through the Neighbourhood Health Service • Integrating digital technologies to replace analogue methods • Moving from treating ill health to preventing ill health • Strengthen the staff workforce through increasing skills, motivation, and sustainability • Drive transformation through new innovations, such as AI technologies • Adapt NHS funding to improve productivity and financial sustainability | • Does the innovation deliver care at a lower cost? • Does the innovation reduce unnecessary testing, appointments, or hospital admissions? • Is the innovation scalable without large increases in ongoing costs? |
| Reducing waiting times for patient care | • Shifting from a hospital to a community setting through the Neighbourhood Health Service • Integrating digital technologies to replace analogue methods • Strengthen the staff workforce through increasing skills, motivation, and sustainability • Drive transformation through new innovations, such as AI technologies • Adapt NHS funding to improve productivity and financial sustainability | • Does the innovation speed up the time taken to diagnose, treat, or refer a patient? • Can the innovation improve patient flow through the system compared to current solutions? • Does the innovation reduce bottlenecks in services? • Does the innovation enable faster access to advice or treatment? |
| Improving access to care | • Shifting from a hospital to a community setting through the Neighbourhood Health Service • Integrating digital technologies to replace analogue methods • Moving from treating ill health to preventing ill health • Shift the NHS from a centrally driven system to a locally driven system • Drive transformation through new innovations, such as AI technologies | • Does the innovation make it easier for patients to reach services? • Does the innovation support patients who face barriers to care such as due to their location or having a disability? |
How do I find the market fit of my innovation in the NHS?
An innovation can sit in or across different settings depending on its nature. Identifying the market fit of an innovation is crucial to ensuring that the innovation will deliver the intended benefits, integrate smoothly with existing services, and address the specific needs of patients or staff within that environment. This section rates how closely the benefits of an innovation fit within each setting. These ratings are based on our team’s expertise and experience and are intended as guidance. There are currently no formal published references or standard frameworks for these ratings.
Increasing staff time savings
| Care type | Relevance | Why |
| Primary care | High | Reduced staff workload and consultation times |
| Secondary care | High | Improved hospital efficiency |
| Tertiary / specialised care | Medium | Helps a small volume of specialist staff |
| Community care | Medium | Time saved on visits and coordination |
| Mental health care | Medium | Reduced administrative tasks |
| Palliative care | Medium | Supports coordination but less frequent system-wide admin |
| Urgent and emergency care | High | Important for speed in triage and patient flow |
Reducing hospital referrals
| Care type | Relevance | Why |
| Primary care | High | GPs decide referrals to hospital |
| Secondary care | Low | Receives referrals to hospital |
| Tertiary / specialised care | Low | Specialist care that does not aim to reduce referrals |
| Community care | High | Treats patients at home instead of within hospital |
| Mental health care | High | Prevents crisis escalation to hospital or hospital admissions |
| Palliative care | Medium | Can reduce unnecessary hospital admissions |
| Urgent and emergency care | Medium | Can reduce avoidable A&E attendances |
Improving patient outcomes
| Care type | Relevance | Why |
| Primary care | High | Early diagnosis and management of long-term conditions |
| Secondary care | High | Acute treatment, surgery, and interventions |
| Tertiary / specialised care | High | Complex or rare condition treatment |
| Community care | High | Recovery, rehabilitation, and long-term support |
| Mental health care | High | Recovery, relapse prevention, and wellbeing improvement |
| Palliative care | High | Quality of life and symptom control at end of life |
| Urgent and emergency care | High | Life-saving interventions that improve survival outcomes |
Reducing cost per patient
| Care type | Relevance | Why |
| Primary care | High | Prevents expensive hospital treatment |
| Secondary care | High | Shorter stays and refer complications, resulting in reduced costs |
| Tertiary / specialised care | Medium | High-cost care, with a smaller population impact |
| Community care | High | Avoids hospital admissions and long stays |
| Mental health care | High | Reduces inpatient and crisis service costs |
| Palliative care | High | Avoids unnecessary hospital treatments at end of life |
| Urgent and emergency care | Medium | Reduces repeat A&E use and admissions |
Reducing waiting times
| Care type | Relevance | Why |
| Primary care | High | Faster GP access and triage |
| Secondary care | High | Reduces hospital waiting lists and bottlenecks |
| Tertiary / specialised care | High | Improves access to specialist services |
| Community care | Medium | Can speed up discharge and free hospital capacity |
| Mental health care | High | Reduces therapy and crisis waiting lists |
| Palliative care | Medium | Faster access improves end of life planning |
| Urgent and emergency care | High | Improves A&E flow and reduces delays in treatment |
Improving access to care
| Care type | Relevance | Why |
| Primary care | High | Easier GP access |
| Secondary care | Medium | Improved referral pathways and remote consultations |
| Tertiary / specialised care | Medium | Easier access to rare specialist services |
| Community care | High | Care delivered locally or at home |
| Mental health care | High | Digital access, crisis support, wider reach |
| Palliative care | High | Better access to end of life support at home |
| Urgent and emergency care | Medium | Faster triage and routing to correct services |
Who would pay to commission the innovation?
The organisation that commissions an innovation varies depending on the care setting:
- Primary care:
- The Department of Health and Social Care directly commissions GP services and national programmes
- Integrated Care Systems also hold local budgets for community services
- Primary Care Networks can also commission local services. Although GPs are paid by the NHS, they operate as independent businesses and may decide to fund innovations themselves. GP practices can work with PCNs or GP federations, which can enable collective adoption of innovations and provide a more scalable route for innovators.
- Secondary care:
- Integrated Care Systems allocate funding across hospitals
- NHS trusts manage hospital budgets
- Tertiary care:
- The Department of Health and Social Care commission specialised services
- Specialist NHS trusts may also commission innovations
Overall, innovations are most likely to be commissioned by the NHS when they can clearly demonstrate measurable value against current system priorities, not just technical capability. Understanding where your innovation fits, who it benefits, and who pays for it is essential to successful NHS procurement.