Health and Social care Committee

Access to medical technologies in Wales

MT ToR 15 Welsh Health Specialised Services Committee (WHSSC)

Health and Social Care Committee: Access to Medical Technologies in Wales

1. There is a lack of clarity and absence of process for evidence evaluation, assessment and prioritisation.

2. As a consequence, many technologies do not have a formal assessment nor are the technologies considered within an evaluation process linked to a Prioritisation Framework.

3. Some new technologies are introduced  by clinicians in an unplanned way without an appropriate assessment of the clinical and cost consequences.

4. The essential objective governing the introduction of any new technology  is the requirement for assessment to determine whether there is evidence that the technology is clinically effective and also cost effective.

5. New technologies in themselves do not necessarily produce better outcomes for patients.  

6. Within the terms of reference, the Committee should consider:

· The absence of a current formal process for assessment and evaluation of new technologies in Wales;

· The methods available to evaluate the clinical and cost effectiveness of new procedures and which organisation(s) should do this;

· The processes for assessment of health service priorities and which organisations have a formal Prioritisation Framework embedded in the planning cycles.

7. Welsh Health Specialised Services comment on the current appraisal processes for new medical technologies: 

NICE have an expanded programme for the assessment of new technologies: Medical Technology Guidelines and Interventional Procedure Guidelines. These guideline reports are not mandatory which causes confusion on the part of patients as well as clinicians who assume that a technology with a positive report from NICE should be funded and therefore available within Wales.

A recent example is the introduction of flow diversion devices for patients with large cerebral aneurysms (NICE MTG10) where Welsh Health Specialised Services will now assess the strength of the clinical and cost evidence within the context of the Prioritisation Framework for the Annual Plan 2013/14.

8. Comment on the decision-making process in NHS Wales on funding new medical technologies / treatments:

The Health and Social Care Committee may wish to consider the detailed comparative evaluation process within:

a. The work of the All Wales Group on Prioritisation (Chair, Dr Sharon Hopkins, Director of Public Health, Cardiff & Vale UHB);

b. The current WHSSC work on the Prioritisation Framework for the Annual Plan for Specialised Services led by Dr Geoffrey Carroll, Medical Director, WHSSC.

DR GEOFFREY CARROLL

Medical Director

Welsh Health Specialised Services Committee

3 October 2012