Oli Hudson, of Wilmington Healthcare, explores how the NHS is enabling more proven and cost-effective technology to be rolled out nationwide.
It was recently announced that around 400,000 additional people would benefit from new tests, procedures and treatments this year in line with the NHS Long-term Plan, which promises to accelerate the uptake and spread of proven and affordable innovations.
The new offerings are being delivered as part of the NHS’s Innovation and Technology Payment (ITP) programme, which aims to fast-track the roll-out of the latest technology across the country.
The ITP 2019/20 builds on the NHS Innovation and Technology Tariff (ITT) 2017-2019 and the ITP 2018/19. All of these initiatives aim to help the NHS embrace innovation by removing financial and procurement barriers.
Innovation and Technology Payment (ITP)
The ITP 2019/20, which was launched last September, is part of wider NHS activities on innovation. These are led by NHS England (NHSE) and delivered with support from the Academic Health Science Network (AHSN). The ITP aims to help NHSE adopt innovative medical devices, diagnostics, and digital products that are both proven and affordable.
NHSE chief executive Simon Stevens recently confirmed that a raft of new technological innovations was being introduced across the NHS as part of the ITP, which provides a clear route to market and opportunities for widespread adoption.
Innovations being supported include:
- Placental growth factor (PIGF) based test – A blood test to help rule out preeclampsia in women suspected to have the condition who are between 20 weeks and 34 weeks plus six days of gestation, alongside standard clinical assessment.
- High sensitivity troponin test – A blood test that when combined with clinical judgement can help rapidly rule-out heart attacks.
- Gammacore – A hand-held device that delivers mild electrical stimulation to the vagus nerve to block the pain signals that cause cluster headaches.
- SpaceOAR – A hydrogel injected between the prostate and rectum prior to radiotherapy, that temporarily creates a space between them so that the radiation dose to the rectum can be minimised.
- HeartFlow – Advanced image analysis software that creates a 3D model of the coronary arteries and analyses the impact that blockages have on blood flow to rapidly diagnose patients with suspected coronary artery disease.
Successful products are identified through a competitive process led by NHSE. To ease adoption, NHSE reimburses individual NHS Trusts for the cost of using an innovation, or they have centrally procured innovations and technologies for use in different geographical areas.
To be selected for the ITP, products need to meet the following criteria:
- NICE support (through a Medtech Innovation Briefing or Guidance)
- Positive in-year return on investment
- Use in at least three NHS organisations
NHS Innovation and Technology Tariff (ITT)
The NHS Innovation and Technology Tariff (ITT) was launched in April 2017, in partnership with AHSNs, so that NHS sites in their regions have access to and can benefit from the latest innovations. In many cases an innovation may be funded under a simple zero cost model, where Trusts order an innovation directly from the supplier at no cost and NHSE then reimburses the supplier directly.
The ITT programme offers funding for 24 months, after which funding may be renewed for some innovations and technologies.
Products that were funded during the 2017/19 round included:
PneuX – a pneumonia prevention system, which is designed to stop ventilator-associated pneumonia.
myCOPD – a web-based application for the self-management of chronic obstructive pulmonary disease (COPD).
EpiScissors-60 – guided mediolateral episiotomy scissors to minimise the risk of obstetric injury.
Urolift – an alternative surgical procedure that can be performed as a day case for benign prostatic hyperplasia (BPH)
Non-Injectable Arterial Connector Implementation – an arterial connecting system to reduce bacterial contamination and the accidental administration of medication.
Focus on low cost innovations
Although the ITP and ITT encompass a wide range of clinical areas, they cover a fairly narrow range of technology. They favour lower cost innovations that provide evidence-based and affordable solutions to problems that have been clearly identified by the NHS. Such products are less likely to require extensive and costly training for staff. However, applicants can enhance the value of their products by managing any training that is needed.
For example, the ITP-supported innovation SpaceOAR offers a proven and cost-effective solution to the debilitating side effects that can be caused by radiation on the rectum during treatment for prostate cancer. The product is projected to save the NHS £15 million a year and is applicable to 35,000 patients. All the product training is provided by the manufacturer, Boston Scientific.
Both the ITP and ITT are expected to announce new themes annually and these are likely to be dictated by AHSNs. For companies with lower cost innovations that meet specific NHS requirements and deliver measurable benefits, these funding sources provide exciting opportunities for widespread adoption.
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