Medtech innovations to have accelerated uptake under new tariff

Posted on 2 November 2016 (Permalink)



Medtech devices and apps will for the first time be included under NHS national payment rules helping to accelerate uptake, NHS England Chief Executive Simon Stevens has announced today. The commitment to create a new Innovation and Technology Tariff was announced by Mr Stevens in June.

Now following clinical review, the first six innovations have today been selected as part of a new Innovation and Technology Tariff (ITT), benefiting women giving birth, patients with chronic lung problems, men having urological surgery, and acutely ill inpatients. NHS England is also, in parallel, backing new mobile technology solutions for diagnosing heart problems.

The new tariff will help cut the hassle experienced by clinicians and innovators in getting uptake and spread across the NHS. It will remove the need for multiple local price negotiations, and instead guarantee automatic reimbursement when an approved innovation is used, while at the same time allowing NHS England to negotiate national ‘bulk buy’ price discounts on behalf of hospitals, GPs and patients.

NHS England Chief Executive Simon Stevens said: “The NHS has a proud track record of world firsts in medical innovation but getting wide uptake has often been far too slow. Our new payment system brings clarity on fast track funding to get groundbreaking new treatments and technologies to NHS patients. Many of them not only improve care but will save the NHS money too.”

The innovation categories that subject to approval will join the national NHS payment scheme are:

  • Guided mediolateral episiotomy scissors to minimise the risk of obstetric injury – Approximately 15% of births in England require the woman to have an episiotomy. Of these, around 25% experiences a complication called Obstetric Anal Sphincter Injury, which causes anal incontinence and which may require reconstructive surgery. Using acute 60 degree angle episiotomy scissors during childbirth reduces the risk of this life changing complication. Preventing these injuries dramatically increases the quality of lives of new mothers who have undergone this procedure and halving litigation costs alone could save the NHS in the region £23.5million.
  • Atrial connecting systems to reduce bacterial contamination and the accidental administration of medication – Although rare, accidental injection of intravenous medication into an atrial line can lead to catastrophic injuries which sometimes require major amputations. Innovations that ensure this does not happen will increase patient safety in NHS hospitals.
  • Pneumonia prevention systems which are designed to stop ventilator-associated pneumonia – 100,000 patients are admitted for ventilation in the UK critical care units each year and 10-20% will go on to develop ventilated associated pneumonia (VAP). Between 3,000 and 6,000 people die from this type of pneumonia every year and prevention would save many lives. Treating VAP costs the NHS between £10,000 – £20,000 per patient and conservative estimates for prevention are savings to the NHS of over £100 million.
  • Web based applications for the self-management of chronic obstructive pulmonary disease – Digital applications for the self-management of COPD can improve the quality of life for patients living with COPD. They give patients the ability to manage their condition by more effective use of their inhalers, support self care and complement face to face pulmonary rehabilitation programmes.
  • Frozen microbiota transplantation for recurrent Clostridium difficile infection rates – Faecal microbiota transplantation is a treatment for clostridium difficile infection. It is an effective alternative to antibiotic treatment for CDI at a comparable cost. High cure rates (90%) and reduced use of antibiotics equal a win-win for patients and the NHS.
  • Prostatic urethral lift systems to treat lower urinary tract symptoms of benign prostatic hyperplasia as a day case – An alternative surgical procedure for Benign prostatic hyperplasia (BPH), a common and chronic condition where the enlarged prostate can make it difficult for a man to pass urine, leading to urinary tract infections, urinary retention, and in some cases renal failure. This is an alternative to existing surgical treatments – TURP (transurethral resection of the prostate) or laser. These existing treatments involve cutting away or removing existing tissue, require an average hospital stay of 3 days and often catheterisation for many days post-surgery. This procedure uses adjustable, permanent implants to pull excess prostatic tissue away so that it does not narrow or block the urethra. Following the procedure, patients return home after a few hours, typically without catheter, and follow-up is normally by telephone. Patients have significantly fewer side effects (notably 0% risk of permanent sexual dysfunction) and post-operative complications, such as infection and bleeding, compared with existing alternatives. The procedure is increasingly carried out under a local anaesthetic.

Separately from the tariff, there will also be central funding for CCGs to purchase mobile ECG devices, which patients can use to identify and measure atrial fibrillation through mobile ECG technology. Early detection of atrial fibrillation in patients helps to prevent stroke, a serious and life-threatening medical condition which can lead to long periods of rehabilitation and decreased independence and enjoyment of life for the patient and huge costs to the NHS.

Peter Ellingworth, Chief Executive of Association of British Healthcare Industries said: “This welcome new approach from NHS England will help ensure a robust, accessible and effective scheme that provides timely patient access to a wide range of medical technologies. We look forward to working with NHS England to implement these changes – and helping to develop an expanded scheme for 2018/19.”

NHS England will directly fund the costs of six of the selected innovations in 2017/18 and will evaluate the impact of the Innovation and Technology Tariff in improving patient outcomes and increased efficiency across the NHS. It will expand the number of innovations covered by the tariff for future years, through a wider scheme that has been designed with industry, the NHS and the Academic Health Science Networks.

Dr Liz Mear, chair of the AHSN Network and Chief Executive of the Innovation Agency, said: “We welcome NHS England Chief Executive Simon Stevens’ announcement of the innovation categories that will be supported by the new innovation and technology tariff. The NHS Innovation Accelerator (NIA) has highlighted a range of barriers and enablers to accelerating the adoption of innovation across the NHS, including financial challenges. We are therefore particularly supportive of the new payment system offered by the ITT, which provides a reimbursement route for NHS providers implementing approved innovations. As well as providing a payment to cover the cost of evidence-based innovations, this will also help to increase access to ground-breaking new treatments and technologies for patients and population.

“Improving outcomes and providing patients with more equitable access to the latest health products and services remains a key priority for the NIA. As such, we are encouraged by NHS England’s commitment to expanding the number of innovations covered by the Tariff in future years.

“Four innovations on the NIA programme currently match the specifications of the ITT. In recognition that accelerated uptake requires a multi-faceted approach – in addition to financial levers – and to help optimise the impact of the new tariff, the AHSN Network will continue to support innovations that are included in the ITT; and also work with current and future NIA Fellows in their ambitions to scale high impact innovations across the NHS for patient benefit.”

The aim of the NIA is to deliver on the commitment detailed within the Five Year Forward View, creating the conditions and cultural change necessary for proven innovations to be adopted faster and more systematically through the NHS, and to deliver examples into practice for demonstrable patient and population benefit. For more information visit the NHS England website