Why the NHS must make innovation its top priority

By Dr Richard Dune

An in-depth look at the fourth shift the NHS urgently needs, moving from research to reality to strengthen care across all system parts.

When people across Africa think of the UK’s National Health Service (NHS), they often think of excellence, world-class teaching hospitals, cutting-edge medicine, and free care at the point of delivery. For many Zimbabweans in the diaspora, the NHS is not only a place of work but also a lifeline for their families and communities. But beneath that reputation lies a system now in critical flux, and the stakes have never been higher.

With the dissolution of NHS England, budget pressures on Integrated Care Boards (ICBs), and uncertainty over future innovation funding, we are seeing the end of a chapter in British healthcare. Yet this moment also offers a unique opportunity: to reshape the NHS into something more resilient, equitable, and innovative, particularly for the communities that have often been overlooked.

Earlier this year, the Wellcome Trust issued a powerful directive: make research and innovation the fourth strategic shift in the NHS. This new shift should sit alongside three long-standing goals:

• From hospital to community
• From sickness to prevention
• From analogue to digital.

But here’s the truth: the other three shifts can’t succeed without the fourth. The system will continue to buckle under pressure without innovation in everyday NHS practice, especially outside major hospitals.

Many Zimbabweans working in health and social care across the UK are not based in elite hospitals like Cambridge or Imperial. They work in care homes, GP practices, district nursing, home care services, and mental health support roles. Yet innovation and research funding rarely reach these corners of the system.

If we truly believe that healthcare happens in the community, research and innovation must follow. But today, those working on the frontlines often lack:

• Time and capacity to engage in research
• Digital infrastructure to trial new models of care
• Access to funding that supports local innovation.

This is where the disconnect lies, and where the opportunity begins.

The NHS isn’t just struggling with inertia; it’s navigating a storm:

• The end of NHS England means fewer national levers for rolling out innovation.
• ICBs are expected to lead transformation despite deep cuts to resources.
• National research funding is drying up, while academic health science networks are in flux.
• Staff morale is low, public trust is fragile, and political leadership is uncertain.

And yet, innovation can’t be an afterthought. It must be a daily part of delivering care, from the inner-city clinic in London to the remote outreach teams in Cornwall.

To move From Research to Reality, we need five bold changes, especially in community and primary care settings:

1. From passive patients to empowered citizens – Let patients contribute to research and service design. With tools like the NHS App, communities can share data and shape their health outcomes.
2. From a culture of fear to a culture of experimentation – Frontline staff need time, space, and incentives to trial new approaches. Innovation time should be built into contracts and encouraged at every level.
3. From isolated projects to embedded innovation – Research should be a routine part of community care. Let’s build hubs where innovation isn’t just displayed on PowerPoint slides but actively applied to patient care.
4. From bureaucracy to agility – Cut the red tape. Speed up ethical approvals. Invest in cross-sector “test beds” that allow for faster, evidence-based decision-making.
5. From pilot projects to scaled solutions – Support doesn’t end with a pilot. There must be funding and national encouragement for scaling ideas that work. Innovation must not die in committees.

This is not about research for its own sake. It’s about:

• Faster, more accurate diagnoses through AI and remote monitoring
• Delivering care at home rather than in hospitals
• Reaching underserved communities – including the African diaspora in the UK

For those of us from Zimbabwe and across Southern Africa, this conversation matters more than we might think. Many of us are part of the NHS workforce. Some of us are carers, nurses, consultants, therapists, or tech innovators. We see the cracks in the system every day, but we also see the possibilities.

Innovation is not just the responsibility of those in power. It’s a shared duty, especially for those on the frontline, those building health and social care businesses, and those leading change in community settings.

What lessons can Zimbabwe and the wider region draw from this? That innovation in healthcare doesn’t have to wait for billion-pound hospitals. It can start in clinics, mobile health units, digital tools, and grassroots participation. Just like the NHS must now reimagine itself from the ground up, many African systems have the opportunity to leapfrog legacy issues and build responsive, community-led health models using research, data, and locally relevant solutions.

For those working in or with the NHS, this is also a moment to shape the system from within, by championing local trials, sharing insights, and refusing to let bureaucracy block progress.

As the NHS evolves in this new post-structure era, let’s not wait for permission to innovate. Let’s build a system where research is part of daily life, not a distant concept confined to academia. Because without this fourth shift, the other three won’t just stall—they’ll collapse.

And for the NHS, diaspora communities who rely on it, and global health systems looking on, there is no future without innovation.

Dr Richard Dune is the CEO of LearnPac Systems, a leading UK provider of edtech and compliance software solutions for regulated sectors. He specialises in governance, compliance, and innovation in both public and private sectors. He can be reached at [email protected] or +44 24 7610 0090.