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The lack of information about the performance and value for money of medtech products is leading to ineffective procurement and wasting scarce NHS funding, a senior government official has told HSJ.
The Department of Health and Social Care’s MedTech director David Lawson told a roundtable organised by HSJ this month that “unwarranted variation” in the procurement process was “tying up funding that could otherwise be deployed to adopt and accelerate the use of the most effective medtech”.
The NHS spends around £10bn each year on medical technology according to government estimates.
Mr Lawson blamed the “variation” on the “lack of information” about the medtech products that would let “decision makers at a local level… make informed, evidence-based decisions.”
He stressed the local level was the right place for decisions on the adoption and procurement of medtech to take place. But added that hospitals did not “have the infrastructure in place to enable informed decision making.”
This was not their fault he said, and noted the DHSC did not “give guidance to hospitals on how to evaluate medical technology” or how they should “assess and validate claims [made] by industry.”
Mr Lawson continued: “To support adoption of the most effective technology, we need to have visibility on existing variation for similar products.”
Doing all of this he added would “ensure a focus beyond simply unit price, [and] on key areas such as potential impact on improving a patient pathway or reducing the risk to patient safety.”
It would also ensure that suppliers were “clear on what evidence they need to provide to sell into the NHS.”
Suppliers currently “often have to have a different conversation and go through different evaluation processes with each individual hospital” commented Mr Lawson. “So, there’s no surprise you see huge variation in decision making, and why the adoption of the most effective technologies, especially for a new supplier, can be so challenging.”
There are other barriers to adoption that need to be addressed, Mr Lawson added, citing the lack of incentives within the NHS to adopt new technologies.
He cited an example of a piece of technology used during endoscopy that can remove the need for bowel cancer patients to have complex surgery.
“Because it’s a procedure [using] an endoscope, the maximum tariff income per procedure is about £1,500” he said, adding that this only covered half the cost of the procedure.
However, the price a trust could charge for doing full [bowel] surgery “is about £30,000”, he said.
The intervention improves patient experience, reduces lengths-of-stay and helps reduce the backlog of patients waiting for surgery, he said. “But from a business point of view, it would not be sustainable because of the financial mechanism within the NHS”.
Date: 17 September