‘The most cutting-edge system in the world for Group have quantified the financial impact the use of technology to improve our health, of just some of the available technologies. make our lives easier, and make money go Our Keeping Britain Working report revealed further’. That’s Secretary of State for Health that just eight technologies - including sepsis Matt Hancock’s vision for the NHS, whose diagnosis equipment, coronary angioplasty, ambitions include modernising the way and hip and knee replacements - have the the health service delivers care to patients potential to save the economy almost half a through cutting-edge mobile and IT solutions. billion pounds a year from reduced healthcare Medical technology however - from medical costs and benefit payment savings. devices to in-vitro diagnostics, imaging equipment and ehealth - already plays an The postcode lottery enormous role in serving NHS patients. In fact, - alive and well still around half-a-million different technologies It would make sense for patients to have are available, with the health service equal access to medical technology regardless allocating around £6 billion a year to this area. of where they live. Sadly though, this has long This technology delivers considerable been a challenge for the NHS. The main reason benefit to the NHS. It often increases is the way the health service is structured. efficiency, reducing the need for further Devolution of decision-making to local NHS intervention and long-term treatment, organisations means that the final decisions reduces costs by limiting hospitalisations, on which treatments are offered locally and and improves patients’ quality of life. under what circumstances is governed by It can also deliver wider societal individual Clinical Commissioning benefits, helping people return Groups and hospital trusts. to work and care for family The existing Around members. In fact, studies by organisation - alongside half the Work Foundation and budget constraints million -athe Medical Technology - only serves to d prolong the postcode techno ifferent lo lottery, as local g ie availab le, wit s are health services find
allocatin h the NHS g £6 billio around n a yea r to this area
increasingly more creative ways of controlling spending by restricting access to treatments and technologies. A recent investigation by the Medical Technology Group has revealed that CCGs are failing to comply with national guidelines on which treatments should be made available. What’s more, when a CCG restricts access, there’s very little the local population can do to change policies. Our study, conducted in October 2018, took four common proven treatments: cataract surgery, hernia repair, Continuous Glucose Monitoring, and hip and knee replacement. We then looked at the lists of treatments restricted by CCGs. These ‘Procedures of Limited Clinical Value’ (PoLCV) - which are normally reserved for complementary therapies or cosmetic procedures where there is little or no clinical evidence to prove their cost effectiveness or clinical benefit - are, according to the Royal College of Surgeons, generally not funded by Commissioners. The results were startling. We found that, despite all four treatments being recommended by NICE, CCGs across the country are deliberately restricting access to them or applying high thresholds to limit the number that are carried out.
Written by Barbara Harpham
Barbara Harpham, chair of the Medical Technology Group, argues for equal access to medical technology and says that treatment should be based on their clinical needs, not patient postcode
Medical technology
Base clinical decisions on patients’ needs, not postcodes
Cataract surgery Our research revealed that 104 out of 195 CCGs include cataract surgery on their PoLCV lists. Cataract surgery is the most common operation performed in the UK, and NICE national guidelines clearly reinforce its costeffectiveness, indicating that it has a ‘high success rate in improving visual function, with low morbidity and mortality.’ Under current national guidelines, the extent to which a patient’s eyesight is affected by cataracts should not determine whether or not they receive treatment. Instead the condition’s impact on patients’ quality of life should be the determining factor. Nevertheless, a third of CCGs list a visual acuity threshold as a requirement for receiving treatment. E Issue 19.2 | HEALTH BUSINESS MAGAZINE
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