Adopting ADHD technology across the NHS helps tackle waiting list challenge
Outcomes and learning
Outcomes
National NHS rollout of QbTest started in April 2020 via the network of the 15 local health innovation networks.
Despite the impact of the pandemic, QbTest rollout gained rapid traction throughout NHS trusts and paediatric services: all targets for adoption, set by NHS England pre-pandemic, were exceeded. It has gone on to achieve outstanding positive impacts.
The rapid rollout was enabled by the health innovation networks' twin abilities to operate locally – supporting local NHS clinical teams with adoption – while working in consistent and coordinated ways across England to drive rapid implementation.
This saw the programme go from a standing start to national adoption within 4 years.
In March 2023, NICE published a medtech innovation briefing highlighting the benefits of objective testing technology when used as part of a comprehensive ADHD assessment. And in September 2024, NICE published diagnostics guidance recommending QbTest to support ADHD diagnosis for children and young people. QbTest is the only technology recommended by NICE at the time of writing to support ADHD assessment for children and young people.
The fantastic success of this implementation across England has provided a launchpad for Qbtech, the innovator that developed the QbTest; the company has expanded internationally and in October 2024 achieved the milestone of completing 1 million tests worldwide.
Between April 2020 and March 2024 (the latest available annual data) the following positive outcomes have been achieved across the NHS in England:
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Implemented within 79 NHS trusts– around 3 quarters of all trusts that provide ADHD services for children and young people.
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71,102 patients benefited.
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Total NHS costs savings estimated at £38.5 million.
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95,097 hours of healthcare capacity released (clinical appointments and school observations).
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41,582 clinical appointments saved.
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2,506 NHS staff trained to use the technology.
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An estimated 375,546 miles of travel avoided by reducing the number of outpatient appointments and school observations – equivalent to travelling to the moon and halfway back.
The initiative has won 4 national awards including 2 Health Service Journal (HSJ) awards:
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HSJ Award 2019 – Innovation in Mental Health.
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National Mental Health and Wellbeing Awards 2022 – Innovative Mental Health Intervention.
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HSJ Partnership Awards 2022 – Best Mental Health Partnership with the NHS.
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2023 Innovation Spread winner at the national Innovate Awards.
Learning
National rollout of this technology across the NHS, from a standing start, provided valuable learning relevant to any NHS transformation programme.
It is important to distinguish between innovation implementation, and implementing innovation in ways that maximise the chances it becomes sustained as 'business as usual' – the latter has been achieved with QbTest.
A blueprint document has been produced by the Health Innovation Network (the collaboration of the 15 local health innovation networks) to capture and share this knowledge. The guide identifies the 5 core areas that must be considered for any NHS transformation programme to be successfully implemented and sustained. These are:
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understanding the context
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raising awareness
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building will
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supporting implementation
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changing behaviour.
Other key learnings include:
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Collaboration between research (NIHR) and innovation (health innovation network) partners, and the commercial innovator (Qbtech, inventor of the QbTest) was critical to successful rollout at scale and pace. So this is an outstanding example of 'bench to bedside' adoption of research outputs into innovation implementation.
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The ability of the health innovation networks to build on the initial NIHR research, by rapidly testing and evaluating promising innovations in real-world settings (in the case of QbTest, the 3 East Midlands NHS trusts), was essential. This provided the evidence base needed by other NHS trusts to adopt the technology.
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The ability to draw upon an innovation support infrastructure (via the 15 local health innovation networks) that could operate both nationally and locally: the health innovation networks' national network enabled coordinated and consistent adoption across regions, and the individual connectivity of each individual health innovation network within its local ecosystem enabled the programme to be adapted for local NHS needs.
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