I had a really interesting chat with someone who works with local authorities highways department this weekend. He told me a story which highlights exactly why regulation is not only the enemy of innovation but also can be fatal. In this case regulations were roadblocks to solving problems and fostering innovation.

He told me about a blackspot for accidents in Kent, a roundabout to be more precise. He told me that after numerous attempts they had adopted a danish model, which had proved successful in reducing accidents. Sounds great, learning from others, implementing new approaches, progress… all good so far.

He then told me that they are likely going to face fines from central government, because the idea falls outside of the regulations. He was very frustrated as they had already tried everything within the regulations and the problem still persisted.

One Size Doesn’t Fit All

Now, I do not mind regulations when they act as a clear safeguard, but regulation that actually causes potential harm? It felt like a ‘catch all’ rather than a solution to a problem. Now I know this is not always the case but it highlights a number of issues which are reflected in other industries.

• Local vs National – Sometimes you need to look at an issue through a localised lens, national regulation tends to be broad and restrictive and does not take context into account.
• Failure to loosen regulation can do more harm than good, which is the antithesis of what they were designed to do.
• Money is constantly wasted on meeting regulation rather than solving the actual problem.
• Those who design said regulations are often detached from the situation on the ground.

Now I have said this before and I will say it again, I would never advocate for people to be ‘gung ho’ with taxpayers money, or take unnecessary risks with peoples wellbeing. But the alternative we see does not solve the issues and actually creates the very situation you wished to avoid.

In the example above millions have been wasted with no resolution and now more money will be wasted ironically because a resolution may have been found that falls outside the ‘rules’.

NHS: Chasing the Emperor’s New Clothes

This issue isn’t confined to local government; we see similar patterns in the NHS as well..I see all the time. The centre tells Trusts that they need to do x, termed as something akin to national standards. The standards don’t solve the local context problem and Trusts waste a lot of money trying to appease these edicts.

Let me provide an example albeit not technically a regulation, the NHS dearly wants to improve workforce planning, so they introduce the Levels of Attainment for Job planning and Rostering. These are designed to assess how well trusts implement and use systems to optimise workforce planning and deployment….productivity.

The problem is they don’t. People are waking up to the fact that they are investing in the ‘Emperor’s New Clothes’. Even NHS Englands own data show they don’t work. Greater access to systems, lower productivity. Why is that? well it is because they are seen as meaningless paper-chases. Yet Trusts still are pushed to enact them. Money keeps piling into a solution that doesn’t work. Seems like a bad idea to me.

How NHS Regulations Stifle Innovation

When it comes to regulations, there are a few areas in the NHS where they could be argued to really hold things back:

The procurement process is a prime example—overly complex and slow, it prioritises cost-efficiency and risk management over innovation. Smaller, agile companies with fresh ideas often struggle to compete, slowing the adoption of new technologies.

Data protection rules like GDPR are vital for patient safety, but they can also create unnecessary barriers, especially when it comes to sharing data for research and technology development. This slows down progress in areas like AI and digital health, which rely on data to drive improvements.

Then there’s clinical trials. The stringent requirements, while important for safety, drag out the process, delaying the introduction of cutting-edge treatments and devices.

A culture of risk-aversion also plays a role. The focus on strict compliance often stifles experimentation with new care models, even when they might offer more efficient, personalised solutions.

Licensing new technologies is another bottleneck, with regulatory bodies taking too long to approve innovations, even those with clear benefits.

Staffing regulations don’t help either. They tend to be rigid, limiting flexibility in workforce models that could improve efficiency and patient outcomes.

Finally, funding models are outdated, rewarding volume over value. Innovative solutions that don’t fit neatly into the existing frameworks struggle to gain support, preventing long-term improvements.

A System That Needs Flexibility, Not Strangulation

No one can solve complex problems when they are either focused on the wrong solution or find themselves in a straitjacket. Imagine being asked to solve a Rubik’s cube but you can only have one rotation. This may work if the cube is 99% solved but not if it is only 1% solved.

The Case for Less Regulation, More Innovation

I appreciate I sound like a broken record, be less risk averse, less regulation, more innovation and clarify intent. Like many topics I comment on, I only comment on them because I am passionate about change. I want to see improvements, not endless platitudes and meaningless hope.

People have put too much effort in and there is too much at stake, especially in NHS for us to let it fail or be paralysed by regulation. On that note I asked chat GPT to try and calculate the number of work hours that had gone into building the sustaining the NHS from inception to the present day. Now, while I’m not saying this estimate is entirely accurate, ChatGPT calculated around 94 billion hours. With 10’s of billions of hours of effort invested in the NHS, should we continue on this rigid path, or is it time to break free from ineffective regulations and embrace innovation?