New report from the Medical Technology Group calls for patient organisations to be more closely involved in commissioning decisions and for ICBs to open transparent routes for industry engagement
A new report from the Medical Technology Group has called on Integrated Care Boards to draw more systematically on the expertise of patient organisations and life sciences companies as they take on their expanded role as strategic commissioners under the new Health Bill.
Driving Collaboration: The Role of Culture, Structures and Finance in Reforming the NHS draws on the group’s previous Ration Watch research looking at the inequity of patient access to technologies and argues that the NHS continues to face systemic and cultural barriers when it comes to spreading such innovation.
The report argues that patients and industry groups are consistently under-used in addressing this at an ICB level, describing the latter as limited to a “traditional supplier-customer relationship” that means evidence and implementation expertise are confined to single systems despite their potential to be useful in decision making elsewhere.
The Health Bill currently passing through parliament abolishes NHS England and provides ICBs with greater commissioning powers, including across primary care and diagnostics.
The MTG describes this as a significant opportunity for a more collaborative operating model, with local leaders able to commission across pathways instead of individual episodes of care.
However, it warns that in many ICBs currently facing significant reorganisation, the framework and culture for collaboration is not yet in place. The report’s recommendations have subsequently called on the DHSC to introduce a formal collaboration and outcomes framework for every ICB, more transparent processes for collaboration between NHS and industry, and the systematic involvement of patient groups in commissioning decisions.
The report points to the Rapid Access Valve Assessment (RAVA) pathway as an example of effective collaboration, a model that was developed through patient workshops with Heart Valve Voice to improve the diagnosis and detection of heart valve disease.
The latest report is part of the Medical Technology Group’s Commission on NHS Culture for Innovation, a year-long research project that aims to understand how systems can be made more accountable for patient access to technology and innovation, as well as understand the barriers to reform envisaged in the Ten Year Health Plan.
“The reform of the health service is asking ICBs to increasingly commission across whole pathways rather than buy services episode by episode, a positive step but one that also demands a rethink of how NHS leaders collaborate with patients and industry,” said Barbara Harpham, Chair of the Medical Technology Group.
“Patients have a great understanding of the pathway from beginning to end, while industry often holds useful evidence on what has worked elsewhere.
“Yet we continue to see systemic and cultural barriers when it comes to involving these groups early on in decision making around commissioning and procuring technologies, an outcome that is hampering patient choice and ensuring that access to proven solutions and models of care is often dependent on where you live.
“Successful collaborations that bring together clinicians, patients, commissioners and industry to tackle shared challenges in the NHS do exist, but we need to ensure that the culture and the framework exists to ensure this happens consistently across the system.”
The MTG is calling for:
- Patient organisations and patient representatives to be part of system-level decision-making. ICBs should be required to involve them in strategic commissioning decisions, pathway redesign and innovation adoption.
- Structured engagement frameworks between the NHS and industry. Every ICB should establish a transparent process through which industry can engage in pathway redesign, population health challenges and innovation opportunities, allowing systems to access expertise and evidence while maintaining appropriate governance.
- For the Secretary of State to use new powers in the Health Bill powers to intervene where collaboration has failed, with intervention focused on systems where organisations consistently fail to collaborate, where variation persists despite available solutions or where poor partnership working is demonstrably affecting patient outcomes.
