Innovation but precious little evaluation: time for more IDEAL-ism in prehospital care?

‘The Trust was keen to be innovative, and to be at the forefront of embracing new practices and technology, in order to improve the care provided to patients. While this is to be commended… the pace of innovation was too quick.’

This section of the Healthcare Commission's (2008) report of its investigation into Staffordshire Ambulance Service could arguably apply to every ambulance service. On the one hand, most people involved in prehospital care are motivated by a desire to do the best for our patients, and to be seen to be ‘ahead of the curve’ where new technologies are concerned. On the other hand, we need to ensure we protect our patients from harm— not least the risks associated with new interventions that are innovative but have not been subject to robust research to demonstrate their safety, efficacy and cost-effectiveness.

On that latter point, we have a wider duty at the ‘population level’ to safeguard taxpayer's money and not waste it on ineffective (or worse) innovations. This can be a difficult balance in an area of healthcare characterized by: