We are engaged with NHS England on several projects within the Specialised Services area, and have a working group dedicated to this topic.
Specialised services are those which are provided in relatively few hospitals, accessed by comparatively small numbers of patients but with catchment populations of usually more than one million. These services tend to be located in specialised hospital trusts.
NHS England is responsible for commissioning £15.6 billion (2015/18) of specialised services to meet a wide range of health and care needs. These include a range of services, from renal dialysis and secure inpatient mental health services, through to treatments for rare cancers and life threatening genetic disorders.
Commissioning through Evaluation
NHS England’s Commissioning through Evaluation (CtE) programme helps a limited number of patients access treatments that are not funded by the NHS, but which show significant promise for the future, while new clinical and patient experience data are collected through a formal evaluation programme.
We are in discussions with both NHS England and NICE (who operate the scheme on behalf on NHS England) to address issues within the process. The output of CtE will link to the new Innovation Tariff which will be announced in the 2017/18 Tariff Engagement.
High Cost Device Procurement
This introduces a novel “zero cost” model together with a centralized procurement and payment system. It was originally outlined by NHS England in its Commissioning Intentions for 2016-17 and is referenced in the 2016/17 National Tariff Payment System under Local Pricing Rules: Rules for high-cost drugs and listed procedures as well as in latest proposals for the 2017/18 – 2018/19 National Tariff.
The intent of centralised procurement is to save £60m over two years on the specified devices, by reducing the variation in acquisition cost and in “pass through” costs. We have established a close working relationship with the NHS England team.
The Accelerated Access Review has identified a need better systematic identification of medtech innovations. We are working with NHS England, NICE and NIHR to develop a Medtech version of Pharmascan. Initially the remit will be limited to devices used in Specialised Services, but the intent is that it will eventually cover all medical technology.