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The United Kingdom's Medicines and Medical Devices Bill was a key item of healthcare legislation outlined in the Queen’s Speech in December. As well as setting out new regulations for medical devices such as pacemakers, breast implants, and ultrasound imagers, it aims to reduce general practitioner (GP) appointments by increasing the range of professions able to prescribe medicines in low-risk circumstances. It also paves the way for National Health Service (NHS) hospitals to use innovative, personalized medicines for unique cancers and diseases.
Health Minister Baroness Nicola Blackwood stated her determination to “help everyone who uses our world-leading NHS to access pioneering, cutting-edge treatments as soon as possible” giving it “further freedom to innovate to improve the lives of countless people and protect patient safety to the highest standards.”
One of the aims of the bill is to ensure the NHS evolves to reflect to the new wave of healthcare innovation. It’s a mantra that we have heard from successive Secretaries of State for the past two decades, as they have championed the importance of innovation of the adoption of new medical technology by the NHS.
Their enthusiasm has resulted in more than 20 different reviews, reports, recommendations, and initiatives. The question, however, is how effective have all the proposed steps been in ensuring the latest technology gets into the hands of doctors and improves outcomes for patients?
The Medical Technology Group has been monitoring the impact of these initiatives, first analyzing the issue in our "Déjà Review" report in 2016. The title reflects the sense of frustration we felt from a distinct lack of progress and tangible results.
The report set out nine recommendations, such as ensuring that the Academic Health Science Networks (AHSNs)—established by NHS England in 2013 to spread innovation at pace and scale across regions—played a central role. Above all, it emphasized the need for the new Accelerated Access Review (AAR), the government’s much-anticipated plan to speed up access to innovative healthcare and technologies and improve efficiency and outcomes for NHS patients, to learn the lessons from previous initiatives.
So how much was our advice heeded? And how fertile is the NHS’s innovation landscape now?
Our latest report, "Our NHS: A Spotlight on the Innovation Landscape," examines those questions. Our conclusion is that the NHS system for innovation adoption is healthier than it’s ever been.
We found that the Accelerated Access Collaborative (AAC), which has become the new umbrella organization for UK health innovation, is now providing leadership and guidance for development of innovation across the health service. It is gaining the prominence and leadership it needs to make a significant impact on the innovation landscape. It now addresses the fundamental challenges to the uptake of new technology, rather than simply identifying products for accelerated regulatory approval, in effect becoming a "single front door" to the innovation ecosystem. The AAC also now plays an important role in horizon scanning, spotting the best new innovations coming down the track, and is developing a local and national approach to ensure the market understands what the NHS needs.
The AHSNs have also grown in prominence, facilitated vital interaction between industry and the NHS, and connected academic organizations with the third sector. In fact, their role as "catalysts and connectors" has been extremely successful. With the help of the 15 AHSNs, more than 330 technologies have been introduced, bringing benefits to more than 20 million patients. The government has renewed their license and funding until 2023, putting them in pole position to continue to deliver results and build on their regional links.
So where can the infrastructure be improved?
While many AHSNs deliver excellent results, more could be done to replicate these successes in other regions. Links with industry could be better, too, so that device manufacturers benefit from insight that enable them to tailor their innovation to the NHS and the source of demand.
Similarly, results by the AAC with a limited number of technologies have been impressive, but rather than picking winners, it should be attempting to resolve some of the fundamental issues that slow down the rapid uptake of technology across the wider healthcare system. The AAC is without doubt the key organization focused on the adoption and use of innovative technology, so it needs a higher profile within the NHS, a more formal role in all aspects of innovation, and should be supported.
Other organizations—such as the NHS Innovation Accelerator, NHSX, and HealthTech Connect—also have the potential to contribute to delivering innovative new medical technology.
In our view there are five additional ways in which innovation adoption in the NHS can be supported:
- NHS England should establish an Early Access to Medical Technology scheme that provides funding and support for NHS organizations to ensure medical technology reaches patients sooner.
- A seamless joined-up process that supports all technology through the evaluation, commissioning, reimbursement, and procurement challenges is needed.
- A medical technology funding mandate should be created to support the uptake of proven, cost-effective medtech.
- Changing the "less is better" mind-set—the most-effective way of reducing demand is to get people back to full health as quickly as possible through access to effective diagnostic and subsequent treatment for all.
- Finally, more needs to be done to create a "culture of innovation" and this comes from the very top—the Secretary of State for the Department of Health and Social Care, Matt Hancock, himself.