‘Buck stops’ with Matt Hancock to ‘encourage culture of innovation’

More needs to be done to encourage a “culture of innovation” to ensure widespread early patient access to technology, according to a new report.

This change in culture needs a top-down approach and “the buck stops with Secretary of State for the Department of Health and Social Care (DHSC), Matt Hancock”, it states.

The Medical Technology Group (MTG) report, Our NHS: A spotlight on the innovation landscape, makes several recommendations on access to medical technology, joining up the system, funding and innovation.

Barbara Harpham, chair of MTG, said: “Creating a culture of innovation needs to come from the very top of Government and the buck stops with the Secretary of State himself.

“His commitment to technology is welcome, but he now needs to go beyond the exciting initiatives and embed a culture that really drives the adoption of new technology in the UK health system.”

In order to accelerate the uptake of medical technology, and to give patients quicker access to these innovations, it calls on NHS England to establish an Early Access to Medical Technology scheme that provides funding and support for NHS organisations – similar to the Medicines and Healthcare products Regulatory Agency’s early access to medicines scheme.

The availability and access to funding for the uptake of proven, cost-effective technologies also needs to be addressed, the report found.

“The criteria for technologies achieving mandatory funding is initially very narrow, and focused on in year savings, the MTG would like to see this extended, with a funding mandate that is similar in operation to that of the system for pharmaceuticals,” it states.

“The NHS needs to look at the vital elements of the system that impact the use of medical technology and ensure they are joined up. This would require a seamless process that supports all technology through the evaluation, commissioning, reimbursement and procurement challenges.

“All evidence, data and information on technology gathered during the evaluation phase should also support the latter elements. Doing this more effectively would allow for a reduction in the amount of duplication.”

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Medical Technology Group recommendations in full:

• An Early Access to Medical Technology scheme is needed, providing funding and support for NHS organisations to ensure patients benefit from the right medical technology for their condition
• The Innovative Technology tariff/payment should be reformed so that it enables system-wide adoption of proven technology
• Devices, like drugs, with a positive health technology appraisal from NICE and are proven to be cost effective, should receive mandatory funding
• NHS procurement mechanisms need to prioritise value over upfront cost
• Health Technology Assessments (HTAs) should look at a wider range of benefits, such as the impact on social care and people’s ability to return to work
• The ‘less is better’ mindset, whereby initiatives aim to reduce demand by removing treatments, needs to change. Instead the focus should be on getting people through the system and back to full health

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The group previously reviewed the impact of innovation on the NHS in 2016 and raised concerns that decision-makers were not learning the lessons from past initiatives, called for a system-wide adoption of technology and for NHS England and DHSC to maintain long-term commitment to the Accelerated Access Review (AAR).

Four years on, the company found the current system is “giving more focus to innovation and uptake than ever before”, namely through the establishment of NSHX and maintaining commitments to the AAE and Academic Health Science Networks (AHSNs).

“The AAC is providing leadership and guidance for development of innovation across the NHS. What is more encouraging is that it appears to be gaining the prominence and adequate leadership to ensure that it makes a significant impact to the innovation landscape,” the report states.

“It should now be supported so that it can take the lead in innovation development.”

But it recommends that the AAC is given greater support, more prominence in the NHS architecture, as well as a more formal role in all aspects of innovation.

While it has focused on supporting the limited uptake of a small number of technologies and delivered results in certain fields, the process is “unlikely to solve the fundamental issues that slow down the rapid uptake of technology across the wider healthcare system”.

The report called for the NHS Innovation Accelerator to be given more prominence and increased capacity to support more technologies across the healthcare system.

“The number of reviews, reports, and initiatives to stimulate the uptake of innovation in the NHS over the past 13 years has now topped 20. While it’s encouraging to see that some of these steps are finally starting to lead to more adoption, it’s time to ensure that the value of technology is recognised and that patient access to proven medical technology is properly funded across the country,” Harpham added.