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The NHS needs to change – to cope with the future health needs of our community.  We want and deserve the best healthcare.  A January 2018 Kings Fund report1 suggests that the NHS R&D Spend per annum us £1.2bn with only £50m spent on implementation.  Is investing more money the way forward or do we need to revisit our approach to innovation.  This talk will address practical ways (with real examples and associated outcomes) to deliver new ways of working in the NHS.