The Government has today announced funding of up to £86 million as a first step in taking forward the Accelerated Access Review. The funding is split into four packages:
- £39 million of funding to the Academic Health Science Networks (AHSNs), to assess the benefits of new technologies and support NHS uptake of that that deliver real benefits to patients according to local need.
- £35 million Digital Health Technology Catalyst for innovators – which will match-fund the development of digital technologies for use by patients and the NHS.
- Up to £6 million over the next 3 years to help SMEs with innovative medicines and devices get the evidence they need by testing in the real-world, building on existing opportunities such as the Early Access to Medicine Scheme (EAMS).
- £6 million Pathway Transformation Found to help NHS organisations integrate new technologies into everyday practices – which will help overcome more practical obstacles such as training staff on using equipment.
Commenting, Health Minister Lord O’Shaugnessy said: “The government’s ambition is that NHS patients get world-leading, life-changing treatments as fast as possible. That can’t happen unless we support medical innovation and tear down the barriers – like speed to market and access to funding – that can get in the way, especially for SMEs. Our investment in innovation shows how much we value the UK life sciences sector.”
The new Department of Health ministerial responsibilities have now been announced. Lord O’Shaughnessy, Parliamentary Under Secretary of State for Health, is the minister responsible for the uptake of new drugs and medical technologies as well as the life sciences industry. O’Shaughnessy is also the ministerial lead for the Medicines and Healthcare products Regulatory Agency.
Meanwhile, Steve Brine MP, Parliamentary Under Secretary of State for Health, is the ministerial lead for NHS England while Philip Dunne MP, Minister of State for Health is the ministerial lead for NHS Improvement.
Following last week’s General Election, at which two serving Health Ministers lost their seats, Number 10 has announced the new Ministerial team at the Department of Health. Steve Brine MP and Jackie Doyle Price MP have joined the Department as Parliamentary Under Secretaries of State – their full Ministerial responsibilities are yet to be announced.
With the major parties all committed to further increases in healthcare spending, much of the debate in this area in the run up to the General Election has been dominated by a single acronym: STPs – sustainability and transformation plans. The Conservative manifesto pledges the continued introduction of STPs as part of the party’s commitments to implementing the Five Year Forward View (FYFV), provided they are ‘clinically led and locally supported’. Meanwhile, Labour has pledged to ‘halt and review’ their introduction, stating that they are ‘looking at closing health services across England’. In this environment, it is worth exploring what exactly STPs are and how they will impact the health technology sector.
What are STPs?
NHS England states that STPs are ‘place-based’ plans responsible for improving health and care services in their local areas, and are ‘built around the needs of the local population’. STPs are partnerships between NHS England and local councils, and are also supported by NHS Improvement, the Care Quality Commission, Health Education England, Public Health England and NICE. There are 44 of them across England and they hold responsibility for the local implementation of the Five Year Forward View.
Why have they been set up?
As explained by NHS England, STPs have been set up to help meet the so-called ‘triple challenge’ identified in the Five Year Forward View: achieving better health, transformed quality of care delivery, and sustainable finances. Clearly, the key challenge set out in the FYFV was the £22bn financial gap that it identified would open up by 2020/21 and NHS England sees the establishment of STPs as a key step in driving efficiencies.
What impact will STPs have on the NHS and what does this mean for health tech?
Respected health think tank The King’s Fund describes STPs as marking ‘a decisive shift away from competition as a means of improving health services by requiring NHS organisations to collaborate with each other and with local partners’. Although there is no sign that STPs will replace CCGs, it is widely expected that they will increasingly be used to coordinate commissioning plans. This is intended to assist NHS England in finding efficiencies through commissioning at scale. It is clear that, if STPs continue to be introduced, companies in the health tech sector will need improve their understanding of the changing commissioning environment and the challenges and opportunities it brings.
Critics of STPs have claimed that their development has lacked involvement from patients, the general public and staff and that local authorities also have not been engaged with sufficiently. Furthermore, some STP proposals which would change the roles of hospitals and specialist services in their communities have attracted criticism.
What does the future hold?
After a series of delays, draft proposals for all 44 STPs have been published and are now being discussed by a range of stakeholders, including clinicians, local staff and communities, trade unions, the voluntary sector and others. With most polls still predicting a majority Conservative government, it is very likely that – despite their troubled beginning and likely future obstacles – the introduction of STPs will continue.
NICE is launching the Medtech Early Technical Assessment (META) tool that will allow for medical technology to reach patients faster. Members of the Health Tech Alliance were given an exclusive look at the tool at a recent meeting, hearing from Carla Deakin (Associate Director – NICE Office for Market Access) and Deborah Morrison (Senior Scientific Adviser, NICE Scientific Advice).
It was explained to members that the tool will help medtech companies generate evidence to show that their products are both clinically effective and cost effective. The META tool will need to be paid for by companies, and is intended to help them identify what evidence a company needs in order to satisfy payer requirements. The tool can be licensed by partner organisations working with medtech companies, which will make the tool available internationally.
The tool is the outcome of collaborative work between NICE’s Scientific Advice service and the Greater Manchester Academic Health Science Network (GMAHSN). The Health Tech Alliance has been invited to attend the official launch of the META tool on the 3rd July. The event is free to attend and online registration is available here.
Last week, Theresa May launched the Conservative manifesto. The manifesto included a number of eye-catching pledges of relevance to the health tech sector and the NHS more broadly.
Regarding technology, the manifesto committed the Conservatives to:
- Implement the recommendations of the Accelerated Access Review to ensure the NHS gets the best value for money and ‘remains at the forefront of innovation’.
- The ‘most ambitious programme of investment in buildings and technology the NHS has ever seen’. Therefore enabling ‘more care to be delivered closer to home by building and upgrading primary care facilities, mental health clinics and hospitals in every part of England’.
- Expand the number of NHS approved apps that can help monitor care and provide support for physical and mental health conditions.
- Pilot the live publication of waiting times data for A&Es and other urgent care service.
Away from technology, the other headline health announcements were:
- To increase NHS spending by a minimum of £8 billion in real terms over the next five years.
- To support the implementation of the Five Year Forward View through the introduction of Sustainability and Transformation Plans ‘providing they are clinically led and locally supported’.
- To introduce a Mental Health Bill – the first for 35 years.
- To ‘make it a priority’ in Brexit negotiations that 140,000 EU nationals working in health and care system ‘can carry on making their vital contribution’.
The manifesto’s references to health tech, specifically the commitments to implement the recommendations of the Accelerated Access Review and embark on ‘the most ambitious programme of investment in buildings and the technology the NHS has ever seen’, are welcome. Details on the latter promise remain light currently. However, it will be interesting to see whether the Prime Minister releases any further information on this in the remaining weeks of the campaign.
Yesterday’s leaked Labour manifesto, made available only hours before it was to be signed off, offers an insight into the party’s plans for the NHS – an area of policy which the party typically polls well on.
The manifesto commits the party to over £6 billion extra in annual funding for the NHS and sets out plans to establish a new Office for Budget Responsibility for Health to oversee health spending and scrutinise how and where it is spent.
Labour say they will halt Sustainability and Transformation Plans, create ‘NHS Excellence’ – a new quality, safety and excellence regulator, and repeal the Health & Social Care Act.
Whilst the leaked document is light on health tech, it does mention a commitment to ensuring “that NHS patients get fast access to the most effective new drugs and treatments”.
Health policy is yet to properly be debated in this election campaign, which thus far has been understandably dominated by Brexit. The Party and its leadership may, however, continue to feel that the NHS is one area where they could and should be polling higher than the Tories.
Health Tech Alliance hear about forthcoming Science and Innovation Audit at Med-Tech Innovation Expo 2017
The Health Tech Alliance attended the first day of the Med-Tech Innovation Expo 2017 at the Ricoh Arena in Coventry this week. Supported by MedilinkUK and Med-Tech Innovation, amongst others, the Expo heard from several industry experts.
Professor John Fisher of the University of Leeds shared the findings of his Science and Innovation Audit. Commissioned by the Department for Business, Energy and Industrial Strategy as part of the Industrial Strategy Green Paper, the Audit is expected to published in July and sets out the barriers to the growth of the health tech sector and solutions to overcoming these.
As the Green Paper states “the UK has too often pioneered discovery but not realised the commercial benefits” and the Science and Innovation Audits form part of the Government’s broader desire to build on the UK’s world-leading science and innovation base.
The Audit undertaken by Professor Fisher will set out the barriers to the sector’s growth including:
- the complex and fragmented innovation/ product development pipeline;
- long lead times on product development and market entry; and
- poor access to NHS alongside a limited ability to evaluate clinical efficacy/ effectiveness
It is also expected to set out several recommendations including:
- greater strategic leadership nationally and regionally;
- investment in national centres of research excellence;
- the development of a national clinical evaluation centre for med-tech devices
The Alliance looks forward to the publication of this vital piece of work which, amongst other things, will highlight the £18 billion annual contribution of the sector in Gross Value Added (GVA) to the UK economy as well as a sector’s projected growth of 64% by 2022.
The Prime Minister’s decision to call a General Election sent shockwaves through Westminster, having repeatedly vowed not to have a snap election at a time when the country needed stability post-referendum.
With the General Election on 8th June, political parties now have approximately seven weeks to outline their offering to the electorate and prove that they can govern in the national interest, as well as somehow balancing the desires of Leave and Remain voters alike.
But what about the impact of the General Election on the health tech sector?
Whilst health tech is unlikely to be or become a key issue during the General Election campaign, the NHS certainly will. You can expect Labour to campaign strongly on providing further funding to the health service (and the party historically polls well on the NHS) – however more money may not necessarily lead to a rise in the adoption of innovative health technologies that could have a game-changing impact on patient outcomes. As a recent Committee report found, the NHS could do much more to take up innovation and technology and overall, there is a lack of clarity as to who should be encouraging its uptake. As the Health Service Journal rightly point out, the Five Year Forward View timetable may now need to be readjusted as it broadly lines up with the previous 2015-2020 election cycle, which has now been broken.
A logjam in policymaking? The industry still awaits a response to the Government-commissioned Accelerated Access Review (AAR). As we approach ‘purdah’, the time period immediately before elections or referenda when restrictions on the activity of civil servants are put in place, the likelihood of a response to the AAR being published before the election diminishes. A formal response to the AAR will help deliver clarity to the industry and set in motion vital changes to the way medical technologies are adopted.
New Ministers and political stakeholders? An election means the possibility of a new governing party (an unlikely scenario based on current polls) but also the chance of new Ministers and political stakeholders. Lord O’Shaughnessy, the Parliamentary Under Secretary of State for Health and Minister responsible for the uptake of medical technologies and new drugs, could be reshuffled post-election. Additionally, you can expect to see changes to memberships of the Health Committee and Science and Tech Committee.
The House of Lords Select Committee on the Long-term Sustainability of the NHS has released a report entitled ‘The Long-term Sustainability of the NHS and Adult Social Care’. Overall the report criticises the ‘short-sightedness’ of successive governments for not planning effectively for the health service. In addition, the report highlights that ‘funding for health and adult social care over the past 25 years has been too volatile and poorly co-ordinated’.
There is recognition that for the NHS to continue to function as it does there will need to be changes. To combat this the report recommends that a new independent Office for Health and Care Sustainability be created, which will look ahead at the health and care needs of the public for the next 15-20 years and report back to Parliament.
Specific focus is paid to innovation, technology and productivity. There is heavy criticism of the ‘NHS’s relative failure to secure the take-up of innovation and new technology at scale’, going further to say that the ‘NHS has been slow to adopt and implement new technology’. Reasons for this are identified as being concerns about cost and the complicated procedures that are in place in order to use new technologies.
There is a clear acknowledgement by the Committee of the power of new technologies and how they can deliver a change in the type of care provided by the NHS. However, the report highlights concerns about the lack of encouragement in the uptake of innovation and technology, and there being a lack of clarity as to who should be encouraging this.
In terms of a way forward, it is clear that the service delivery model for the NHS needs to change. There is also recognition that if the ‘Five Year Forward View’ seems to be the only forward planning that has been done in regard to the health service, which is criticised by the Committee, but they feel that if its findings are fully implemented it will improve the NHS. In terms of technology and innovation the Committee urge that the Government make it clear that the adoption of innovation and technology, post-appraisal, should be a priority across the NHS. They go as far as suggesting that the Government make clear to the bodies and areas within the NHS deemed to be ‘failing’ in this respect that there will be “funding and service delivery consequences for those who repeatedly fail to engage” – including possibly relocating services to places that are proven to be more technologically innovative.