12 Nov, 12 | by BMJ
Despite an increasing number of medical technologies that have the power to save and enhance lives, a high proportion of healthcare professionals still believe that the NHS has been too slow to embrace innovative ideas and technology. Many point out the stark variations in uptake of medical technologies across the country, not to mention the “silo” mentality of the NHS and government as a whole, with little collaboration between those setting budgets and those at the sharp end. The Innovation, Health, and Wealth report, published in December 2011, recognised this slow adoption of innovative medical devices and proposed a number of key measures to try to ensure consistent access. In the context of the changing landscape of the NHS, and together with the pressure to generate cost efficiencies, how can we ensure equity of access to medical technologies?
This was the subject of a lively debate I chaired at a meeting in Parliament last week, which brought together healthcare professionals, industry representatives, patient groups, and parliamentarians. The debate focused on issues around uptake of medical technologies in the UK, and how the new structures could best address the challenge.
There was much discussion around whether the new “levers” identified in the Innovation, Health and Wealth report will help improve access. Certainly the NICE compliance regime and the innovation scorecard are both measures that aim to improve patient access to NICE approved treatments, but it is essential that these are not just seen as “box-ticking” exercises. As one leading clinician pointed out, innovation is critical to the health and social care sector as well as the business sector, but we must ensure adequate adoption on the ground to ultimately improve patient care. For this, he argued, the new academic health science networks are key: they have the potential to transform health outcomes in England by bringing together the local NHS, higher education institutions, and industry to improve the adoption of innovative technologies.
Another hot topic of debate was the postcode lottery that exists around the country in patient’s access to medical devices. A patient representative member of the coalition Medical Technology Group highlighted one particular self testing device for anticoagulation therapy that was being denied to a set of patients in a specific region, even though there is strong evidence to show the benefits. It was agreed that better information for patients and clinicians on the benefits of medical technologies would go some way to alleviating this. The issue is also one of patient empowerment and the well known “no decision about me, without me” mantra. There was further agreement that NHS managers and services leaders must work to support patients to play an integral part in their care pathway decision making.
It is encouraging that, through the policies identified in the government’s Innovation, Health and Wealth report, there has been a renewed focus on medical technologies and their ability to save lives and give value for money to the NHS, patients, and taxpayers. Recent innovations have produced some of the biggest global breakthroughs in clinical science and service delivery methods. The challenge is how to unleash these across the whole system. With the announcement that Jim Easton’s role of national director of improvement and efficiency will not be replaced following his departure, cultural, financial, and political silos need to be put to one side to enable all parties to work together to create a healthcare system that can deliver the vision of the Health and Social Care Act and the Innovation, Health, and Wealth report recommendations.
Ian Liddell-Grainger is conservative member of parliament for Bridgwater and chair of the all party parliamentary group on improving patient access to medical technologies.