Innovation in health care: developments in NHS trusts.

Essential parts of the R&D in virtually all UK biomedical innovations are executed within teaching hospitals, which are undergoing major organizational changes as part of the ongoing NHS reforms. Examines the impact of the changing structural and regulatory environment on the process of biomedical innovation management of two groups of technologically novel projects with the NHS. Finds that regulatory changes were tending to centralize and formalize innovation management, but that end users were playing an active role in directing the course of new treatment development. Problems of allocation of R&D resources within teaching hospitals were still unresolved, although some evidence from the London teaching hospitals suggested that hospital managers were able to deal with conflicting demands where they perceived that research excellence could be an asset rather than a cost.