The Core Needs provides a clear, practical example of how a needs‑led model can be operationalised at scale within mainstream education, moving beyond theory into delivery. It demonstrates how embedding clinical expertise directly into schools transforms access, shifting support closer to children and young people and enabling real-time assessment, observation and intervention in their everyday environment. This approach not only improves timeliness but strengthens relationships between health, education and families, creating a more joined-up system that is easier to navigate.

A key learning point is the power of intervening early with functional, strengths-based support rather than relying on diagnostic thresholds. The model shows that many young people can be effectively supported through a single, well-structured intervention, supported by a period of watchful waiting and clear step-up pathways when required. This has important implications for demand management, demonstrating a credible route to reducing pressure on specialist services while maintaining safe and appropriate escalation.

The pilot also highlights the importance of building capability within schools. By working alongside SENCOs and staff, clinicians are not only supporting individual children but leaving a lasting legacy of increased confidence, skills and consistency within the wider workforce. This creates a multiplier effect, where impact extends beyond the initial intervention and contributes to longer-term system resilience.

From an operational perspective, the pilot identifies critical enablers of success, including strong multi-agency partnership working, clear referral processes, dedicated workforce capacity and a structured delivery model. It also makes clear the risks of not investing, particularly around increasing demand, widening inequity of access and continued reliance on costly statutory pathways.

For decision-makers, the key action is to consider how this model can be embedded as part of the core local offer, rather than as a time-limited pilot. The evidence presented supports scaling through a phased approach, ensuring quality and consistency are maintained while expanding reach. It also prompts a wider reflection on how services can redesign pathways to prioritise early intervention, improve flow and ensure that resources are directed where they have the greatest impact.

Overall, this pilot offers a compelling, evidence-informed case for system change, showing not just what should be done differently, but how it can be delivered in practice in a way that is sustainable, equitable and centred on the needs of children and young people.

More blogs on the hub from Craig Russo:

• Partnership working between A&E, the police and custody healthcare

This toolkit is designed to equip nursing leaders with actionable insights and strategies to redesign care and improve nurse thriving based on findings from this project. By utilising the tools and structured approaches outlined in the toolkit, health care organisations can effectively redesign care delivery solutions tailored to their specific needs and drive meaningful improvements to foster an environment in which both nurses and patients flourish.

Highlights:

• Key learning and examples from a diverse group of health care systems that successfully tested innovative care model redesign solutions to promote a thriving nursing workforce.
• Actionable guidance and resources to support teams with implementation, including specific change ideas, recommended measures, and a checklist for getting started.
• A structured improvement science framework and supporting IHI tools to assist teams in driving meaningful change and sustaining improvements.

Can you tell us more about the histopathology service you work with? 

Our histopathology service focuses on diagnosing diseases by examining tissue samples under a microscope. It is key in identifying conditions like cancer, infections and inflammation. Typically collected through biopsies or surgeries, samples are processed in various ways and we then assess the tissue’s cellular structure to detect abnormalities. 

Our findings guide clinical decisions, such as confirming cancer types, grading tumours and determining treatment options. The detailed reports produced by our service are essential in shaping patient care and are often discussed within multidisciplinary teams for comprehensive treatment planning. 

Are lost samples a problem? 

The stress and anxiety felt by patients awaiting a potential cancer diagnosis can be made much worse if they are told their sample has been misplaced or lost. Unfortunately, this ‘never event’ happens more often than is acceptable across the NHS and globally. 

While working in histopathology, I became interested in clinical systems, digital pathology and sample tracking systems. These systems are used by most NHS organisations, but they are prone to user error and are inherently flawed. They can only provide historical information about a sample's past, rather than its current location, which leads to uncertainty about where these precious patient samples are at any given time. Tissue blocks move constantly around the department to undergo additional processes. Dynamic movement around the department is both a necessity and also adds to the challenge of locating these samples. 

How does your new system work?

From developing an understanding of sample tracking systems, I identified significant opportunities to enhance patient safety. Improvements were clearly necessary, but the technology to enable change still needed to be created. So, with support from the Innovation Pop-Up* I developed a new system. 

Our new system allows continuous, real-time tracking of the cassettes through Radio Frequency Identification (RFID) technology. 

Key elements

• It tells us the precise location of each sample and its movement through our histopathology department. 
• Our custom tag provides the read ranges we require for the technology to work successfully in a clinical environment. 
• Installing antennas and readers throughout the department allowed us to collect live data on the movements of our patients' samples. 
• Our tag provides improved signal ranges, readability, and resilience of RFID technology in harsh processing conditions.  

How was this work resourced and developed?

Thanks to seed funding provided by the Leeds Hospitals Charity, we were able to demonstrate ‘proof of concept’ with the innovation. Demonstrating the technological capabilities of the concept helped support an additional funding application to Innovate UK’s Knowledge Asset funding, which allowed us to scale the system as a minimal viable produce (MVP). 

Without support and funding, we wouldn’t have been able to develop the UK's first real-time histopathology sample tracking system. 

Were there challenges along the way? 

Innovating within the NHS has historically been difficult as the required infrastructure and support mechanisms have yet to be in place. Testing a new and/or unknown technology brings uncertainty and risk. 

Thanks to the support of Leeds Hospitals Charity, our Innovation Pop-Up team and the Pathology departments, we have begun to understand this process more robustly and agilely. This has led to the establishment of new methods for future innovation endeavours to allow more streamlined processes to test, and potentially adopt, innovations and new ideas. 

What’s next for this work?

Although we are still testing and validating the data, we have seen some notable improvements since using the system:

• The RFID real-time tracking system offers never-before-seen visibility and data on our processes, ensuring samples are accounted for from collection to testing. This can reduce the risk of human error, leading to a more rapid turnaround of results and better patient outcomes. 
• Pathologists' workflow can be streamlined as our labs can process samples and generate reports faster, thus optimising pathologist time, allowing for quicker decision-making and treatment initiation.
• The impact on patient care has been incredible. Diagnostic results are being delivered quickly, helping healthcare providers make prompt decisions regarding treatment plans, leading to improved patient outcomes and quicker recoveries.

What advice would you give others wanting to develop innovations in the NHS?

Carrying out due diligence and discovery is vital. Knowing what technology already exists and what current market offerings are available will begin to help shape innovation. Once you understand what you would like to see, explore current offerings to investigate if simple modifications could provide the solution. If this cannot be done, work in collaboration with other departments within your Trust (Scan4Safety, Clinical Engineering, etc.) to seek a solution.

What’s next for this work?

We will continue to collect data on the systems' performance and expand into other areas of the Trust to enhance the data. Once we have enough data, we hope to publish our findings. We are also exploring potential partnerships to help support the commercialisation of this innovation. 

If you are interested in RFID or RFID for Pathology Services, please contact Dil Singh Rathore (Dil.rathore@nhs.net), Pathology Technology & Innovation Lead, Leeds Teaching Hospitals NHS Trust. 

*a support programme at Leeds Teaching Hospitals NHS Trust for clinicians and entrepreneurs with ideas for new products and services that solve healthcare challenges.

Share your insights and innovations

Have you been been involved in rolling out a new way of working that has had a positive impact on patient safety? Could you share your approach and what you have learnt along the way? To find out how you can share your insights via the hub, get in touch with the editorial team at content@pslhub.org or find out how to submit a blog here.

The new guide collates the critical success factors, focusing on five core areas that should be considered for any transformation programme to be successfully implemented and sustained. These are: 

• Understanding the context 
• Raising awareness 
• Building will 
• Supporting implementation 
• Changing behaviour. 

The guide can be adapted to any innovation programme – large or small – and includes example toolkits and resources for project leads. 

• More agile use of resource
• Staff well-being
• Working together
• Accelerated decision-making
• Sustaining the pace of innovation and change
• Digital access and confidence
• Embracing new technology.

Recommendations

The Study report provides 12 recommendations for how decision-makers and practitioners from across NHS Wales can sustain the innovative and transformative ways of working that have emerged.

1. NHS Wales organisations should coproduce an Innovation Strategy with Welsh Government
2. NHS Wales organisations should develop and implement an Innovation Framework and processes to enable innovation
3. Review workforce development approaches to increase innovation capacity across NHS Wales
4. Improve visibility of innovation contact points across NHS Wales organisations
5. Promote, champion and engender a shared purpose and passion for continual improvement
6. Review staff redeployment practices
7. Understand and act upon health and well-being impacts on staff as a result of increased pressure
8. Continue to actively and purposefully integrate health and social care
9. Review governance in relation to decision making
10. Foster and encourage multi- and interdisciplinary networks, for improved long-term agility
11. Ensure no one is left behind within the digital agenda
12. Develop a forward-looking vision and strategy for the safe integration of disruptive technologies that takes into account the future needs of our population.

To access the full detail of the report, follow the link below.

The Model Hospital is broken down into six sections offering different perspectives from which to review hospital activity:

• board-level oversight
• clinical service lines
• corporate services
• people
• care settings
• clinical support services.