Key terms used in this report

Intervention: An intended change to existing practices or services that aims to improve health care. An intervention may consist of a single component or several different components that each contribute towards the intervention’s aims.

Innovator: The individual, team or organisation that developed the idea for the intervention or that first implemented it within the UK.

Spread programme: An initiative aiming to achieve the replication of the intervention in new sites or settings.

Programme leader: The individual, team or organisation leading the spread of the intervention to new sites or settings. (Where the innovator is leading the spread of an intervention they have developed, they will also be the programme leader.)

Adopter: An individual, team or organisation other than the innovator that implements the intervention in a different site or setting to the one in which it was originally developed.

Adaptation: A change made by an adopter to the intervention, compared to the innovator’s original version, as they implement the intervention in a new site or setting.

Codification: A description of the intervention, along with any supporting materials, aimed at enabling others to reproduce it. Codifying an intervention requires thinking through what adopters will need to know in order to reproduce it successfully, for example, what is core to making the intervention work and what can be adapted.

Innovation and improvement: New approaches, practices, treatments, technologies and services that aim to improve health care. The analysis in this report applies to both innovation and improvement; on some occasions we use both terms together, and on others we use one as a shorthand for both. (As described above, we use the term ‘innovator’ to refer to the individual, team or organisation that developed the idea for the intervention, whether it is an ‘innovation’ or an ‘improvement’.) Improvement, including formal quality improvement (QI) using a structured method, is often used to describe incremental change within an existing service model, whereas innovation can be used to mean disruptive change that creates a new service model. Furthermore, innovation is often viewed as a discrete, one-off change, whereas improvement is often viewed as iterative and ongoing. Nevertheless, both innovation and improvement tend to involve one or more interventions (see above) and it is such interventions that are the main focus of our analysis here.

Scaling and spread: Activity that results in an intervention being replicated across multiple sites. Scaling, which is a subset of spread, refers to an initiative to replicate an intervention specifically through a higher-level organisation or geographical entity (such as a professional body or government agency); but spread can also happen through horizontal connections between adopters, without the involvement of a higher-level entity. The analysis in this report applies to both scaling and spread; we sometimes use both terms together, though more commonly ‘spread’ is used as a shorthand for both.

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