Innovation in the medtech sector can offer rapid advances in treatment and efficiency of patient care. However, innovators often find it difficult to cut through and gain recognition. The NHS has made efforts to apply a systematic approach to purchasing decisions, but this has not always been consistent or easy to navigate.
NHS England and the UK health technology appraisal body (the National Institute for Health and Care Excellence, or NICE) have recognised the need to provide a fair and transparent marketplace for innovators while reaping the benefits of these technological advances for buyers and patients. They are developing an integrated, rules-based approach to the assessment and commissioning of medtech.
The proposed system would establish a pathway across the lifecycle of a product from promising early-stage technology through to established medtech in widespread use. A guiding set of principles will inform decision-making and prioritisation.
Principle 1 – the pathway should be supported by evidence-based advice and guidance from NICE, focused on technologies with the greatest impact on patient outcomes and the most compelling cases for clinical and cost-effectiveness.
Principle 2 – the pathway requires a lifecycle approach to support new, early-stage technologies as well as driving greater value from existing technologies in widespread use.
Principle 3 – the pathway should lead to automatic identification of funding to support routine commissioning and adoption for clinically and cost-effective and affordable technologies.
Principle 4 – the pathway should support the transformation of clinical pathways and services.
Principle 5 – the pathway should drive up the quality and use of evidence, helping tackle ethnic and unfair biases in medtech.
The proposals set out in detail the stages from pre-authorisation to scaled adoption. Review of a technology will include gaining input from relevant clinical and policy teams before progressing to the next stage. This may mean that many technologies are set aside through the process, although those that are taken forward will have a good chance of success.
As always with NHS purchasing, there is a strong focus on value-for-money and driving efficiency. However, a clearer system is likely to aid developers in directing their investment effectively. If a technology is widely accepted across the NHS, the potential market is substantial.
These proposals are under consultation until 15 August 2024.
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