The development of innovative and effective healthcare interventions that improve outcomes for patients should be welcomed and encouraged. Such interventions typically include new drugs and technologies, diagnostic tools and surgical procedures, as well as models of healthcare delivery. Before widespread introduction across a health service, we would expect an intervention to have undergone a rigorous assessment of benefits, harms, cost-effectiveness and affordability. So, what are we to make of NHS England's proposal to introduce a sore throat test-and-treat service in community pharmacies as part of its National Innovation Accelerator (NIA) programme?1

The NIA is intended to promote “mature innovations with an evidence base, ready to scale in the NHS, and where there is no easy or obvious mechanism for adoption”.2 As one of eight …