By Cath Barrow, Programme Lead, Health Innovation Manchester

When we first joined NHS England’s Innovation for Healthcare Inequalities Programme (InHIP) in 2023, we knew we were setting out to tackle a significant challenge. Across Greater Manchester, too many children and young people are living with poorly controlled asthma. We know the impact this can have on their health, education, wellbeing and families. We also know that these challenges are often greater in communities experiencing deprivation and other forms of disadvantage.

The ambition of InHIP was simple but important: to use innovation to reduce health inequalities and ensure that children and young people receive the right care, at the right time, regardless of where they live or their circumstances. What followed has been one of the most rewarding, collaborative and insightful programmes I have had the privilege to lead.

Starting with a proven innovation

The programme centered on the use of Fractional Exhaled Nitric Oxide (FeNO) testing, a NICE-approved technology that measures inflammation in the lungs and supports the diagnosis and management of asthma. The initial phase of the programme focused on children and young people attending secondary care services in Oldham before expanding into Tameside and adopting a whole-pathway approach across primary, community and secondary care settings. However, from the outset, we recognised that introducing a technology alone would not address the underlying inequalities affecting asthma outcomes. To make a difference, we needed to understand the wider barriers affecting children and families, strengthen connections between services and design solutions that worked for the communities we were trying to reach.

The power of partnership

One of the biggest achievements of InHIP has been the partnerships that developed throughout the programme. Clinicians, primary care colleagues, community organisations, public health teams, local authority partners, schools and families all played a vital role in shaping and delivering the project. Together we created a model that brought different parts of the system together around a shared goal. As our evaluation work progressed, one theme emerged repeatedly: it was the collaboration between primary care, community services and secondary care that really made the difference. Partners co-designed pathways, adapted approaches to meet local need and found practical ways to embed new ways of working into everyday services. This collaborative spirit enabled us to go beyond a traditional pilot and explore what sustainable change could look like in practice.

Listening to communities

A defining feature of the programme has been our commitment to co-production and community engagement.

Through parent engagement, focus groups and dedicated work with children and young people with special educational needs and disabilities (SEND), we gained valuable insight into the realities families experience when managing asthma. These conversations helped us understand how information is accessed, where barriers exist and how support can be designed to be more inclusive and accessible.

The insights gathered have informed new findings and highlighted opportunities to develop more tailored and accessible resources for children and families in the future. Importantly, this work reinforced a key lesson: solutions are most effective when they are shaped alongside the people who will use them.

What have we learned?

Like any innovation programme, InHIP has generated as many lessons as outcomes. We learned that introducing innovation at scale requires more than equipment and technology. It requires shared understanding, shared goals, workforce capacity, strong relationships, data systems that support delivery and local flexibility to adapt models to different settings.

We learned that integrating care across organisational boundaries can be challenging, but when it is achieved it creates better experiences for patients and more effective pathways for professionals. We also learned the importance of continuous evaluation, not simply to demonstrate impact but to understand where improvements are needed and how successful models can be strengthened and sustained.

Perhaps most importantly, we learned that tackling health inequalities requires a whole-system approach. Innovation is a powerful enabler, but lasting change comes from combining innovation with collaboration, community insight and a shared commitment to improving outcomes.

Building a legacy

Although the InHIP programme has formally come to an end, its impact does not stop here. Throughout the programme we worked closely with partners to ensure that learning, resources and evidence could inform future service development. The evaluation has demonstrated that the model developed through InHIP has the potential to be adopted and adapted elsewhere, helping other areas address similar challenges.

In Tameside, partners are already exploring how the pathway can continue and evolve, building on the foundations established through the project. The programme has also generated valuable recommendations relating to asthma management, early intervention, smoking cessation support, education and system-wide collaboration. For me, this is what success looks like. Not simply delivering a project, but leaving behind stronger relationships, better understanding, new ways of working and a platform for continued improvement.

A final thank you

InHIP has been a truly collaborative endeavour and would not have been possible without the commitment, expertise and enthusiasm of colleagues across Greater Manchester and beyond.

I would like to thank everyone who contributed to the programme, particularly the clinicians, healthcare professionals, partner organisations, community representatives, children, young people and families who generously shared their time, expertise, laughter, ideas and experiences.

Their contributions have helped shape a programme that has not only delivered innovation but has also deepened our understanding of how we can work together to reduce health inequalities and improve outcomes for future generations.

As the programme concludes, I am proud of what has been achieved and optimistic about what comes next. The lessons from InHIP will continue to inform our work, helping ensure that innovation reaches the people who stand to benefit from it most.