The first X-Ray was taken in 1895, and after flirting briefly with being a fun-fair attraction during the early 1900s, and after considerable questioning and doubt of the technology from fellow physicians, it was then routinely adopted in the battle fields of The Great War and went on to revolutionise healthcare diagnostics around the world, impacting and benefitting billions of people’s lives. Great ideas come from all sorts of places, but often take time and effort to realise their benefits fully.
Fast forward to today and the NHS, arguably more than ever, needs to find new and innovative solutions, novel therapies, and technologies for several challenges that we face as a system – whether this be tackling waiting lists, pressure on primary care services or due to wider evolving health and social care demands such as an ageing population or increasing inequalities. However, the NHS has wrestled with the challenge of creating a system that allows and embraces the systematic and strategic uptake and spread of innovation. Tackling this is a key priority of both the the Health Innovation Network and the NHS Accelerated Access Collaborative team and is a key driver in the NHS Long Term plan. One important lever we are using to help providers is through the development and continued support of NHS England’s MedTech Funding Mandate (MTFM) in 2021, which is committed to accelerating the uptake of several innovative medical devices, diagnostics, and digital products to support patient care.
There are currently 11 technologies on the MedTech Funding Mandate, all of which have had to be evidenced by NICE medical technology or diagnostics guidance as clinically effective and beneficial to patients’ outcomes. They also must address health inequalities and ensure that there is equity of access for all eligible patients across hospitals in the East of England.
At Health Innovation East, our role is to create the right conditions and convene the right people to develop and deliver breakthrough products, processes, and technologies to maximise patient impact. So how exactly do you support adoption of medical technology and innovation in a busy and challenging hospital setting? Here are a few ideas that we use to help shape our work.
This is top priority. Yes, technologies need to demonstrate effectiveness through recent NICE MedTech Guidance or Diagnostic Guidance. However, it needs to also be right for the patient. Patients need, and deserve, the right to equitable access to technologies – it is not fair or right that people, due to their postcode, might not be offered access to a technology that could be better for them and their overall health outcomes. This requires coordination across all systems, thorough analysis of the benefits and how they may affect services and consideration of how you can ensure equality is built into your business case and patient and clinical engagement plans.
It’s imperative that we have clinical champions who drive change and foster the energy and desire to implement innovation – the champions for the MTFM products both national and local are experts that can help us to understand the benefits, the processes and the enablers around implementation. Their professional experience and specialist expertise also help us share best practice and case studies to ensure there is the clinical support when implementing the MTFM and other innovation programmes.
We know that NHS staff are incredibly busy and that any transformation or innovation project needs to be sustainable to be worth any short-term time investment. That’s why you need to understand the costs of implementation as well as evidence the potential savings and their relevant timeframe. Each of the 11 technologies included in the MTFM have been assessed against their affordability and potential to support NHS cost savings within three years of implementation (net saving).
Generally, system transformation projects have an impact which spans organisational boundaries. This patient-centred care and integration of services mean the focus is not just about who pays for what or where in the system the saving is seen, but you will need to know the answer to those questions. To bring people with you on the journey, we need to stress where innovation can deliver an improvement across the wider system whilst ensuring patients have equitable access to the best procedures. Only when we do this will we start to see system-wide impact.
True co-production must start with the very people the technologies are designed to support. Yes, the technologies on the MTFM have been developed with patient input but when it comes to local implementation there is nothing more important than engaging with local patient groups with an understanding of challenges in your area to hear how these technologies may benefit them. We can support this through work with the East of England Citizens Senate as well as facilitating patient surveys to support adoption.
Finding the right support and utilising the resources that are there to help are important. This is what we do best at Health Innovation East. We are experts in implementation and adoption of innovation across health systems. We have colleagues and resources to support this with expertise including cost-saving modelling, facilitation of working groups and business case design. We are here to support organisations across the East of England in implementing sustained and meaningful adoption and improvement.
Innovation and technology sit at the heart of better health outcomes for our communities and help us discover and deliver safer, faster, kinder and more effective patient care and ways of working as we develop and learn together. By building innovation into strategies, budgets and infrastructure (e.g. new hospitals planned for our region) we can create opportunities to put innovation and cutting-edge science within the heart of NHS care using our resources sustainably and mindfully.
“For those wanting to adopt MedTech Funding Mandate products I would advise getting a working group together including your clinical and management team, your ICB medicine optimisation contact, the AHSN and the products advisors. By having all the key players together this reduces delays and overcomes any barriers. Speak to centres who have already gone through this process and share tools including business case representation that has previously been successful and adapt this for your purposes.”
The current 11 MTFM technologies cover a range of therapeutic areas from innovations that support treatment of benign prostate hyperplasia (BPH) – also called prostate gland enlargement – and chronic sinusitis to cluster headaches and sickle cell disease. Find out more about the MTFM and the technologies included here.
As an AHSN we are here to support local systems to implement the policy and any plans required to do so. If you are interested in the implementation of the technologies on the MedTech Funding Mandate then please get in touch at firstname.lastname@example.org.
Nick Clarke is a Principal Adviser at Health Innovation East. He has extensive
knowledge of the public health system and has held leadership and
managerial roles at national (Public Health England), regional (DHSC) and
local Government levels.
Placental Growth Factor (PlGF) Testing involves using a simple blood test approved by NICE to rules out pre-eclampsia developing in the subsequent 14 days where women present with hypertension between 20- and 35-weeks’ gestation. These tests are recommended to help plan safe care and a safe birth for people with pre-eclampsia, and also to identify people unlikely to develop pre-eclampsia, and therefore reduce unnecessary hospitalisation. The test was added to the MTFM in 2021 after it was shown to enable more women to be cared for as outpatients and reduce the frequency of outpatient visits and unnecessary interventions i.e., early delivery, reducing costs for mothers and increasing midwife work .
Since its addition to the MTFM Health Innovation East has supported the roll out of the test in all but one of the eligible hospitals in the East of England.
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