Innovation is essential to the NHS's future sustainability and capacity to respond effectively to evolving health needs, yet persistent gaps remain between policy ambition and practice capability. Effectively embedding innovation in healthcare organisations is about more than introducing novel ideas or technologies – it also requires the establishment of enabling structures that support cross-organisational collaboration and strengthen evaluative capacity. The article reflects on a joint initiative between a higher education institution (Liverpool Business School) and an NHS trust (NHS University Hospitals of Liverpool Group). Together, these bodies introduced the Centre for Management Development and Innovation in 2022, as a locally embedded innovation infrastructure. The centre aims to support the co-development, evaluation and governance of health service innovation within a large acute provider context. Its core functions are structured around two interdependent pillars: supporting project-based innovation through outcome mapping, stakeholder engagement and developmental evaluation; and contributing to innovation governance, including the piloting of a bespoke Innovation Impact Assessment Framework. Drawing on the centre's first 18 months of operation, this article explores the tensions and challenges accompanying this model, such as relational legitimacy, reliance on key individuals and the need for more inclusive public involvement. The wider applicability of this approach for healthcare systems seeking to embed and enhance innovation is also discussed.
Knight et al. (2026) studied this question.