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NHS transformation, GIRFT and procurement: what do they mean for MedTech?


Wilmington Healthcare’s free webinar explores how the latest NHS developments are affecting the MedTech industry

A free webinar, recently hosted by Wilmington Healthcare, explored why the MedTech industry must dovetail its procurement strategy with the NHS’s bid to reduce unwarranted variation in patient care and outcomes, and get better value for money for all types of goods and services.

The guest speaker was Dr Vaughan Lewis, Medical Director of Specialised Commissioning, NHS England South, and Clinical Lead for the NHS England Specialised Commissioning High-Cost Tariff-Excluded Devices (HCTED) programme. He discussed the issues alongside Sue Plant, Commercial Director for MedTech at Wilmington Healthcare. The event was chaired by Oli Hudson, Content Director at Wilmington Healthcare.

Among the topics covered were the new NHS Supply Chain Operating Model – which replaces the current NHS Supply Chain – the purpose of which is to eradicate variation in purchasing costs, and Getting It Right First Time (GIRFT), which also focuses on reducing unwarranted variation in expenditure and efficiency across NHS trusts.

These types of efficiency and outcomes-driven initiatives are putting pressure on MedTech companies to demonstrate the value of their products across the whole care pathway and to show how they can deliver cost efficiencies and improve patient outcomes.

Speaking of these changes within the NHS, Sue said: “People in MedTech are finding it difficult to keep pace with procurement-related changes, such as the Future Operating Model and GIRFT. However, they need to really understand the new system-wide integration of health and social care, and the way that budgets and pathways must be adapted, redesigned and evolved.”

The speakers agreed that having a clear evidence base for a product was key in the new NHS commissioning landscape. Sue said: “What we are now facing is a drive to have consistency and real-world evidence to show how products will improve patient outcomes.”

Asked how MedTech companies could provide the required evidence, Vaughan said that collaboration between clinicians, commissioners and industry was likely to be the way forward for MedTech in terms of proving that its products will improve patient outcomes and deliver value to the NHS.

Commenting on the impact of the new NHS Supply Chain operating model for the MedTech industry, Vaughan said that speaking from a clinician’s perspective: “Wherever you are in the country, you pay the same price for drugs, but the same does not hold true for high-cost tariff-excluded devices. There is extraordinary variation in the price different NHS trusts are paying for the same device.

“That’s been highlighted by colleagues in GIRFT and has also become very clear to NHS England during the migration of categories of high-cost tariff-excluded devices into the new national supply system.”

He said that GIRFT had already demonstrated significant cost improvements and ‘critically we were seeing a reduction in unwarranted variation.’

Sue said: “Looking at optimal care pathways versus suboptimal ones is critical for GIRFT. Pretty much every company has in-depth knowledge of its own specialist areas; what its device can do and what benefits it can bring. But expressing it in the right way in a pathway is perhaps something they haven’t had to do before.

“GIRFT presents an opportunity for MedTech companies. However, many of them need to change their approach and look at the care pathway from a national perspective to determine how their product can add value across the whole integrated system of care.”

Vaughan confirmed that, within the new NHS Supply Chain operating model, high-cost tariff-excluded devices fall within two of the 11 NHS procurement category towers service providers, which are each run by an organisation appointed by the NHS. The towers sit alongside existing private purchasing alliances and informal supply alliance agreements between hospitals.

He explained how NHS England and NHS Improvement were working with NHS trusts to reduce unwarranted variation and said: “This, in part, would be achieved through better networking, with high throughput multi-disciplinary decision-making processes in larger centres supporting smaller adjacent NHS trusts to maintain local delivery of specialist services to a high standard where this is clinically appropriate.”

Vaughan believed that nationwide collaboration was key to enabling the NHS to capitalise on the benefits of innovative new technology. He said: “We can only truly harness the population benefits of new technology through collaborative relationships at a national level. The move to a national supply chain puts MedTech onto a national footprint, rather than restricting relationships at provider level.”

He added: I think it is incumbent on industry, clinicians and the wider NHS to work together, to ensure new devices that come to market with significant financial implications are really going to add value to patients. This requires an evaluative phase before being rolled out on a national scale.”

Summing up the discussions, Sue said: “I think from a market access perspective, it’s all about understanding the paradigm shift of how to engage with the NHS. This requires an understanding of the NHS and its new framework form.”

She added: “Companies also need to make a clear case for change and show the NHS how a product fits into the whole care pathway. There are opportunities for full scale pathway design, but to get involved in this, you must really understand the new commissioning landscape and that is a goal for everyone working with the NHS at the moment.”

To listen to the full webinar discussions, visit