Improving The Pathway From SME Innovation To NHS Adoption

The UK’s aspiration to be a global leader in life science and health technologies is one backed up by world-class research and innovation. Yet the pathway from medical technology conception to patient access is slow and rife with challenges.

This is especially true for the NHS, which has historically struggled with an overly supply-driven and top-down approach to innovation¹. The introduction of schemes such as Innovation and Technology Payment through NHS England – created to accelerate the adoption of innovative medical devices, diagnostics and digital products by removing financial and procurement blocks – was a step in the right direction, but systemic barriers continue to stall innovation in the UK at the point of delivery.

For startups, scale-ups and SMEs in particular, the route into the health system remains slow, complex and regionally inconsistent. A 2019 study estimated new medical diagnostic technologies take approximately 10 years to be routinely adopted in the NHS², and while that time frame may be slowly shrinking, there is still a significant amount of red tape preventing startup-led innovation from reaching frontline public healthcare in the UK.

Much of this delay stems from issues with procurement and bureaucracy. With a large organisation like the NHS, needs assessments, market research, tendering, evaluation and contract negotiation can take months, sometimes years to complete, and these lengthy, complex processes often result in increased time and resource.

One notable example is the uptake of insulin pumps in the UK. Insulin pumps have been available for decades and are widely recognised as an effective way to treat Type 1 diabetes, yet in the UK only around six in 100 patients use them³. This isn’t because the devices don’t work, but rather because the NHS has faced barriers like high upfront costs, limited specialist staff and slow, uneven implementation of national guidance.

Indeed, fragmentation of access compounds existing challenges by creating a postcode lottery for innovation. While the NHS is a national health service, procurement decisions and adoption pathways are often devolved to Integrated Care Systems (ICS), hospital trusts and regional bodies, each with its own priorities, budget cycles and evaluation frameworks. For SMEs and startups, this means there is no single, streamlined route to market – a product that is welcomed in one trust might face months of additional assessment in another.

Another hurdle is the removal of NHS England and a renewed scrutiny of Integrated Care Boards, including requirements to cut running costs by 50%⁴. There is significant uncertainty about which commissioning and partnership functions will remain intact moving forward. If assurance and regulatory functions are scaled back, vital checks and collaborative mechanisms could be weakened. This in turn could mean innovation pathways are not only more fragmented, but also harder for SMEs and startups to navigate with confidence – resulting in duplicated effort, inconsistent standards and delays that can drain limited financial and human resources from early-stage businesses.

How do we start to tackle the problem?

One way these issues are beginning to be addressed is through the NHS ‘Innovation Passports’ outlined in the government’s NHS 10-Year Plan. Designed to streamline access to pioneering technologies as soon as they’re ready for deployment, the scheme will allow new technology that has been robustly assessed by one NHS organisation to be easily rolled out to others.

This approach allows SMEs and startups to focus resources on product development and clinical engagement rather than navigating repeated bureaucratic hurdles.

For example, the Innovation Passport could act as a bridge between local success stories and wider national adoption, ensuring that solutions proven in one region can be replicated and scaled across the country without losing momentum.

Local innovation clusters have already proven the merits of co-location as a tool to accelerate progress, with campuses such as Manchester’s Citylabs showing how this model is already working in practice. Located on the Oxford Road Corridor – Europe’s largest clinical academic campus – and developed in partnership with Manchester University NHS Foundation Trust, the UK’s largest NHS Trust, Citylabs provides SMEs with direct access to clinicians, patients, clinical trials and diagnostic collaborations.

This powerful mix of specialist infrastructure and co-located NHS connectivity gives small companies the credibility, collaboration and pathways they need to turn early-stage ideas into technologies with a clear route to patient adoption. It does this by enabling rapid testing, stronger collaboration and clearer commercial pathways from concept through to procurement. This matters because SMEs and startups are not only the source of much of the UK’s medical innovation, but also some of the fastest to respond to shifting patient needs. Any adoption pathway that fails to support them risks stifling the very pipeline of innovation the NHS and wider economy depends on.

So, by aligning regional innovation with national policy, and by streamlining adoption through initiatives such as the Innovation Passport, the NHS has an opportunity to create a faster, fairer and more predictable pathway for technology adoption. This will not only strengthen the UK’s position as a global leader in life sciences but also ensure that patients across the country can benefit from the best innovations at the pace they are needed – rather than at the pace bureaucracy dictates.

What is needed for success?

While this kind of national adoption scheme has the potential to address some of the biggest barriers to innovation, it cannot be viewed as a silver bullet. To deliver meaningful change, it must be supported by the right infrastructure, skills and culture. That means investing in digital systems that can integrate new tools quickly and securely, establishing consistent and transparent evaluation criteria, and ensuring that procurement teams and clinicians have the time and capacity to engage with innovative suppliers.

Above all, the process must remain grounded in what’s beneficial to patients, ensuring that technology adoption is not just faster, but also targeted at the areas where it will have the greatest impact.

While the NHS Innovation Passport scheme sets the right direction on paper, its success will depend on how well it’s delivered, with sustained funding, clear accountability and a practical focus on what works for patients, clinicians and innovators on the ground.