WIREDGOV

techUK responds to the Interim Report for the Accelerated Access Review, which was published yesterday.

Yesterday, Sir Hugh Taylor published his Interim Report for the Accelerated Access Review, which aims to "speed up access to innovative drugs, devices and diagnostics for NHS patients".

The Report sets out where the Review Team have got to in their research in order to test their preliminary analysis and, with stakeholders, use the next phase of the Review to plug gaps and work up the proposals that will make a difference to a level of detail that will support their implementation. The high-level Report outlines five key propositions and key areas for action which, provisionally, the Review Team think can deliver the changes required. They are:

• Putting the patient centre stage: giving them a stronger voice at every stage of the innovation pathway
• Getting ahead of the curve: a radically new approach to accelerate and manage entry into the health system for the emerging products that promise the most significant, potentially transformative, impact in terms of patient benefit and overall value
• Supporting all innovators: in addition to accelerating access to a select number of the most promising new products, the end-to-end innovation pathway can, and should, be more responsive to the wider, irrepressible surge of innovation presented at all levels of the system: particularly where its introduction will contribute to better outcomes for patients and more productive and efficient ways of delivering care.
• Galvanising the NHS: ensuring the NHS is an active partner in promoting innovation, and incentivised to adopt new products and systems quickly and effectively.
• Delivering change: Building on existing health system structures, a new system architecture is required at local and national level to accelerate access to the best new products and related models of care on a sustainable basis, within a framework of collective agreement to
  ambitions and goals.

In response to the news, Natalie Bateman, Head of Health, Social Care and Local Government said,

"The Interim Review presents a promising start for the Accelerated Access Review. It has identified a number of challenges in the adoption and diffusion of digital health in the NHS that we have raised via the Review's Stakeholder Reference Group and the digital health supplier engagement event we ran in partnership with the Review Team and Office of Life Sciences in September.

For example, the Review is right to identify in proposition three the differing levels of support needed by innovators, particularly at the point of entry to the system. The route to market for medicines is very different to that of a digital health or care product - the speed at which innovation develops is significantly faster and there is a larger economy of suppliers. Lengthy and costly evaluation processes have a detrimental impact on our members ability to innovate, and can be a deal breaker for SMEs and start-ups' decision to invest in the UK. Therefore, we are cautious about the proposals for NICE to take a greater role in evaluating digital products and urge the Review to rigorously review – in consultation with techUK – how it could apply to such a different pathway. However what is needed, and is rightly identified in the Interim Report, is to give products the best chance to succeed – through early engagement with customers and end users to understand clinical need – and if it isn't a suitable product, to have an environment where they can fail fast and safely.

Recognition in proposition four for the need to galvanise the NHS to see technology as a solution to its challenges is also welcomed. Digital health and care products are mechanisms of change, but people, both in terms of patients and health and care professionals, are fundamental to the pace and scale at which technology is adopted and diffused. We highlighted in our initial response to the launch of the Review that a priority should be supporting the NHS and Local Authorities in making informed commissioning and procurement decisions about technology. Health and care professionals tasked with making these decisions are not always equipped with the necessary skills or knowledge to effectively navigate the market, identify appropriate innovative solutions, and procure and commission effectively. As such, we have often called for greater clinical involvement in decision making and for technology champions - that can articulate the benefits – to have a seat on Executive Boards of NHS organisations and Local Authorities. We therefore are pleased to see elements of this included in the initial findings and will continue to pursue this during the subsequent engagement phase.

Whilst we recognise that these are initial findings, we would have liked to have seen a greater distinction between the route to market for digital health and care products and the more established pathways for medicines and medical devices. Not all of the recommendations will be suitable for all types of innovation and it is unclear at the moment how this will be addressed. Similarly, we would like to see greater clarity on how 'innovation' is defined, as this will differ between market segments.

We would also like to see greater consideration given to social care and how the Review can help drive forward integrated service delivery. The recommendation to incentivise health economies committed to system integration through new funding models should be explored, but given government's ambition for 'human centric' rather than 'system centric' services, social care needs to be inherent in all five of the Propositions. Particularly given that the benefits of adopting digital technology are often accrued in a different organisation or care setting to the one that commissioned it. Technology Enabled Care Services are a prime example - keeping an elderly person who is prone to falling or has dementia, in their own home, safe and independent, would require the Local Authority to make the investment decision. However, the benefits of avoiding health interventions will reduce the burden on the GP and or local hospital. It is not clear whether these types of innovative products will be considered as part of the Review, even though they offer significant benefits to patients and the NHS."

As techUK has been involved in the developments of the Review since its launch, we recognise the extensive research and stakeholder engagement that has been conducted, and applaud the Review Team for the number of opportunities the digital supplier community has had to respond to date. Our views regarding the need for further focus on digital health and care have been and will continue to be raised via the engagement channels available to techUK. We invite our members to send us feedback on the on the five propositions, in order for the feedback to be considered as part of this ongoing discussion.