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NHS England's Innovation and Technology Tariff

NHS England plans to fast-track the introduction of six new types of medical technology products and apps during 2017/18 through the Innovation and Technology Tariff (ITT). The ITT removes the need for multiple local price negotiations and instead guarantees automatic reimbursement.

For five of the technologies, NHS England will centrally pick up the costs, where these have been incurred in line with requirements about use. The sixth innovation is an alternative to existing surgical procedures, and is already funded as part of tariff calculations.

The innovation categories are:

Guided mediolateral episiotomy to minimise the risk of obstetric anal sphincter injury

Approximately 15% of births in England require the woman to have an episiotomy. Of these, around 25% experiences a complication called Obstetric Anal Sphincter Injury, which causes anal incontinence and which may require reconstructive surgery. Using acute 60 degree angle episiotomy scissors during childbirth reduces the risk of this life changing complication. Preventing these injuries dramatically increases the quality of lives of new mothers who have undergone this procedure and halving litigation costs alone could save the NHS in the region £23.5million.

Arterial connecting systems to reduce bacterial contamination and the accidental administration of medication

Although rare, accidental injection of intravenous medication into an arterial line can lead to catastrophic injuries which sometimes require major amputations. Innovations that ensure this does not happen will increase patient safety in NHS hospitals

Pneumonia prevention systems which are designed to stop ventilator-associated pneumonia

100,000 patients are admitted for ventilation in the UK critical care units each year and 10-20% will go on to develop ventilated associated pneumonia (VAP). Between 3,000 and 6,000 people die from this type of pneumonia every year and prevention would save many lives. Treating VAP costs the NHS between £10,000 – £20,000 per patient and conservative estimates for prevention are savings to the NHS of over £100 million.

Web based applications for the self-management of chronic obstructive pulmonary disease (COPD)

Digital applications for the self-management of COPD can improve the quality of life for patients living with COPD. They give patients the ability to manage their condition by more effective use of their inhalers, support self care and complement face to face pulmonary rehabilitation programmes.

Frozen Faecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection rates

Faecal microbiota transplantation is a treatment for clostridium difficile infection. It is an effective alternative to antibiotic treatment for CDI at a comparable cost. High cure rates (90%) and reduced use of antibiotics equal a win-win for patients and the NHS.

Management of Benign prostatic hyperplasia as a day case (purchased through National Tariff)

In parallel, but separately from the tariff, NHS England is centrally funding the purchase of mobile ECG technology which will be managed through the AHSN network.

We believe these products will offer significant improvements such as reducing outpatient visits, inpatient length of stay and additional treatment/procedure costs. A number of the innovation types address patient safety and all will improve both outcomes and experience.

The Innovation Technology Tariff went live on 1st April 2017 and we are keen to encourage adoption and spread of these technologies. A number of webex were hosted by Mr Robert Chesters, Innovation and Research Unit, NHS England that provided an opportunity to understand the uniqueness of this tariff model.

Subjects that were discussed:

  • The Programme themes
  • The guidance document
  • The role of the CSU
  • Procurement and Supplier flows
  • Reimbursement and reporting flows
  • Payment of suppliers
  • Q&A

If you require support for any projects that you are undertaking that are in alignment with the above categories, please contact: Cara Afzal on cara.afzal@gmahsn.org