Introduction

Released on 16 March 2021, the UK Government’s Integrated Review lays out an ambitious vision for the UK’s Security, Defence, Development and Foreign Policy over the coming decade and beyond.1 Core to this aim is an unprecedented focus on the necessity of purposeful, coherent innovation to deliver novel offensive and defensive capabilities; ones powered by the explosive rate of development in artificial intelligence, automation, cyber, sensing and a host of other digital technologies. The Review recognises that the Government’s security agenda is reliant on support to, and proper exploitation of, the UK’s highly competitive science and technology sector. Implementing the review in this regard will necessarily depend on how quickly defence can convert new knowledge, cultivated from the multiple silos constituting its research and development (R&D) ecosystem, into tangible and deployed capability.

Commercial suppliers must continually appraise opportunities to innovate as they optimise for shifting consumer trends or face commercial decline. A renewed focus on learning from this experience has yielded valuable lessons.2 In the digital space, the most agile and well-financed market players have invested heavily in technical expertise and R&D systems such that the leading edge is typically to be found within private enterprise. Indeed, this reversal of the innovation flow—where once it was Defence leading the agenda—has been implicitly acknowledged by the recent announcement to establish a UK version of the US’ renowned Defence Advanced Research Projects Agency (DARPA) to regain the ‘high-risk, high-return’ ground ceded to industry.3

How, then, should Defence healthcare answer this call to arms, and—given that the UK Defence Medical Services (DMS) is held as an exemplar of an innovative organisation4—is there any real need to look afresh at the DMS’ capacity to innovate at pace?