Healthcare Improvement Scotland is developing its strategic plan for non-medicine technologies.
Aim
The purpose of the strategic plan is to ensure that Healthcare Improvement Scotland plays a lead role in NHSScotland and beyond in relation to the evidence, improvement and scrutiny of non-medicine technologies.
Addressing the challenges and opportunities identified will require both partnership and ownership by a range of key stakeholders across NHSScotland. Our plan is based around thematic areas which reflect the landscape and key challenges. A need to:
- Raise and improve awareness of the importance of safe, clinical and cost effective use of NMT.
- Work collaboratively to understand roles and responsibilities with a wide range of NMT stakeholders including evidence assessment and regulatory organisations, manufacturers and patient and public bodies.
- Improve communication networks and structures to ensure that evidence assessment and improvement information are received and considered by the most appropriate local groups. There is a need for clearer focus and co-ordination for NMT and a clearer landing zone for advice and improvement information.
- Contribute to the development of a shared framework for the assessment of NMT at a local level. There is an opportunity to share local assessment and reduce duplication and improve equity of access.
- A need to support the pathway for assessment of CE marked innovative technologies, ensuring structures are sufficiently flexible to permit assessment and ongoing surveillance.
Help shape our strategic plan
We would like to invite you to comment on our draft strategic plan. You can submit your comments using the proforma below and returning to hcis.shtg@nhs.net.
1. Introduction and aims
Non-medicine technologies (NMT) encompass a wide range of healthcare interventions ranging from devices and diagnostic tests to changes in treatment pathways in health and social care. There are over 500,000 medical devices on the market with an annual United Kingdom (UK) market of £11 billion for medical devices alone and 1 in 25 people have an implanted medical device. This group of interventions may prove to be transformative in the delivery of care, however the assessment and regulatory structures, processes and profile of NMT are significantly less visible than for medicines. Medicines have historically received greater focus within the research community, closer integration to the structures that deliver healthcare and greater prominence in the wider media. There is some evidence that this focus may have produced a mismatch between the priorities of patients and clinicians for research and the research that is actually done (Crowe et al.). Certainly, the NMT arena has received less attention despite an innovative environment, a greater number of interventions with potential safety and risk implications and a significant capital spend. If we are to gain the significant opportunity from NMT for improvement to health outcomes and experience a significantly greater focus and resource is required in the key areas described in this paper.
The aim of our strategic plan is to lead improvement in clinical and cost effective use of non-medicine technologies by working with patients, public and health and social care stakeholders to ensure the best use of evidence and improvement strategies from innovation to adoption
2. Healthcare Improvement Scotland
Healthcare Improvement Scotland is a statutory body that works with healthcare providers to support improvements in the quality of healthcare and empower patient and the public. Our mission is to be the recognised healthcare improvement organisation which drives the delivery of world-class, person centred healthcare in Scotland.
Healthcare Improvement Scotland plays a lead role in NHSScotland in relation to the evidence, improvement and scrutiny of healthcare services. Healthcare Improvement Scotland encompasses assessment and improvement for both medicine and non-medicine healthcare interventions.
We are part of NHSScotland and have four principle functions:
- providing sound evidence for improved healthcare, through the Scottish Health Technologies Group (SHTG), and the Scottish Intercollegiate Guidelines Network (SIGN) and the Scottish Medicines Consortium (SMC)
- supporting the delivery of a safer health service and the reliable spread of best practice in quality improvement
- ensuring the effective participation of the public in the design and delivery of healthcare, principally through the Scottish Health Council, and scrutinising, and
- quality assuring the provision of healthcare.
Healthcare Improvement Scotland's priorities are set out in Driving Improvement in Healthcare: Our Strategy 2014–2020. The 2015–2018 Strategic Delivery Plan for Medicines describes our strategy for improving the use of medicines. This document outlines our plan to improve the use of NMT and outlines our key actions between2016–2018.
3. Methodology
This paper has been developed by a working group; membership described in Appendix 1. Further information was gathered from a questionnaire distributed to NHS boards on national guidance and local health technology assessment processes (Appendix 2). The final version of the document will be submitted through the Healthcare Improvement Scotland consultation process to members of the healthcare community, patients and the public.
4. Definition
NMT describes a diverse range of healthcare interventions extending from devices and diagnostic tests to pathway interventions. In considering NMT, this document aims to reflect the life cycle from innovation to obsolescence.
The proposed definition for NMT, already in use by SHTG, is modified from the International Network of Agencies for Health Technology Assessment (INATHA).
The definition includes:
‘Any intervention, except pharmaceuticals, which may be used to promote health, to prevent, diagnose or treat disease or for rehabilitation or long-term care. This includes devices, diagnostic tests, ehealth, procedures and organisational systems used in health care.’
The wide range of possible interventions means that a focus on specific areas is required to achieve effective improvement actions. The initial areas of focus will be informed by the consultation and reflected in the work plan; likely areas of focus will include work in devices and diagnostics and their related pathways. The landscape for NMT is best developed for devices, which is reflected in this paper, however we acknowledge that the issues faced by devices – including lack of evidence – are more marked for other technologies (eg pathways).
