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Israel and the NHS in COVID

Written by: Kathy Scott - 15th July 2020

Kathy Scott, our Director of Operations considers what we might learn from Israel’s entrepreneur friendly culture when thinking about our own approach to health innovation

Back in February, when COVID-19 was only just beginning to make headlines, I was fortunate enough to be invited on an Innovate UK and Knowledge Transfer Network mission investigating how Israel and the UK could work closely on precision medicine. You can find the report here – it’s a really interesting read and identifies the opportunities of, and barriers to, joint working around precision medicine – which is the name for  technology that enables early and accurate diagnosis to inform patient treatment.  An example of this is using genetic testing to identify which patients have certain genetic mutations and therefore will respond better to specific drugs.

All delegates on the trip were struck by Israel’s entrepreneur-friendly culture. Looking back there are three factors supporting this:

  • Attitude to risk: in Israel, risk is seen a fact of life, something to be embraced rather than avoided.  Likewise, failure is positioned as a learning tool rather than a disaster resulting from personal inadequacies. This ethos is embedded in Government structure and represented in approaches to incentives and funding for entrepreneurs. For example, government funding is translated into a grant if the venture doesn’t succeed (rather than a loan to be repaid)
  • Collaboration: this happens routinely, not only on an individual and team basis, but also on a cross sector basis. Government structures encourage this collaboration and the resulting cross fertilisation.
  • Connections: because of Israel’s National Service policy, Israelis have connections with people from vastly different backgrounds, sectors, geographical areas etc – and they use these connections very effectively, it is expected, and encouraged.

The common theme is that the Israeli government and society are set up to make these three factors work for them, and structures and processes are in place to facilitate and embed this culture.

I firmly believe that an entrepreneur-friendly culture is a good thing. But it doesn’t necessarily guarantee the uptake of the innovation into practice; Israeli health organisations still struggle with uptake at pace and scale.  This is despite these three factors playing a part in an innovation-friendly culture. The AHSN Network knows that NHS Trust Boards with a higher appetite for risk, and organisations that encourage collaboration and support staff in making and exploiting connections, see greater spread and adoption of innovation. To me, this demonstrates that the innovation life cycle needs to be culturally supported all the way through; it is not enough to focus just on one element.

And, over the last 3 months, we’ve seen a huge change in the NHS’ culture and openness to adoption and spread of new stuff. The previously risk averse and partially closed culture has become one of transformation and spread of innovation has increased beyond what we thought was possible.

Part of this change has been a willingness to take risks, to collaborate with organisations and people we’ve not thought of collaborating with before and increased connections across boundaries.  There are other factors as well, outlined in this thought-provoking publication ‘10 leaps forward – innovation in the pandemic’. This change has taken place in the context of a huge issue affecting everyone which has changed the culture, giving implicit and explicit permission to take risks.  Many staff at all levels have felt empowered to do something different to seek better results.

As we move into a future where we live with COVID-19, we need to be able to identify the things we want to keep (and drop) and encourage the culture that supports the spread of innovation at pace and scale. The AHSN Network is involved in this work with the Health Foundation and NHS Confederation.  Is there an opportunity to learn from Israel’s approach of ensuring that Government, Boards and society are set up to support this culture, and not stifle it?