Written evidence submitted by the Health Tech Alliance (DEL0181)

Overview

1. The Health Tech Alliance welcomes this timely inquiry. Given the Alliance’s focus on driving the uptake of proven and cost-effective health tech innovation across the NHS, our response focuses on the role that health tech can and should play in supporting the NHS to deliver its core services and wider community care.

About the Health Tech Alliance

2. The Health Tech Alliance is a coalition of health technology companies and stakeholder bodies from across the NHS and wider health system. This focus on partnership is integral to the Alliance’s overarching objective of industry and the NHS working collaboratively to ensure that vital health tech innovation reaches patients. The Health Tech Alliance is chaired by Dame Barbara Hakin.

Executive Summary

3. Our key points are as follows:

• An undeniably positive change attributed to the COVID-19 response has been the unprecedented manner in which digital and health tech is being adopted.
• Health tech adoption and spread must continue and will be vital in helping the NHS and general public adhering to social distancing measures, which will likely remain for some time.
• The Government must continue to fund and adopt technologies which help the workforce do their jobs under the new ‘normal’ and help patients to still access the care and services they may require.
• The Department of Health and Social Care and NHS England should work hand-in-hand with Clinical Commissioning Groups, Trusts and all relevant parts of the wider health system, including industry, to harness the benefits of health tech.
• The Alliance supports the restoration of ordinary care at this time and NHS England’s ‘Help us help you’ campaign to urge the public to seek care when they need it.
• The NHS should consider how, if at all, the new Nightingale hospitals might use technology or capacity to help supplement ordinary care capacity.
• We strongly believe health tech has a huge role to play in identifying and addressing those aspects of care which have been sub-optimal prior to and during the crisis to reduce waiting lists. Even health tech that is deemed to have an ‘incremental’ impact could dramatically help to alleviate demand and pressures on the NHS and community care.
• As the NHS slowly transitions further towards restoring ordinary care, it is imperative that the emphasis should be on care quality and patient outcomes over unit price.
• For health tech to be truly harnessed, more needs to be done to solve the information governance issues that slow adoption.
• The current limitations around health technology appraisals should be examined and the implementation of the MedTech Funding Mandate should be accelerated and expanded if the NHS is truly to benefit from the health tech which can reduce waiting lists, save money and ultimately save lives.

COVID-19

4. The NHS moved at a remarkable pace to increase critical care capacity, repurpose staff to the frontline COVID-19 response and put in place technology to ensure patients can contact their GPs via remote consultations.
5. This is on top of the monumental efforts industry have made to deliver Personal Protective Equipment (PPE), respiratory support equipment and work to build diagnostic tests to rapidly diagnose individuals that are infected.

6. A positive change of the COVID-19 response has been the unprecedented manner in which digital and health tech has been adopted at pace. Notable examples across primary, secondary and community care include but are not limited to:

• The introduction of GP Connect to all practices to enable secure sharing of patient records across primary care;
• The use of AI to predict critical care capacity, equipment and staffing;
• GP practices carrying out remote video consultations with patients;
• Free access to mental health, meditation and sleep management apps to NHS staff;
• The various digital solutions that have been awarded funding under the TechForce19 challenge to support vulnerable people who are self-isolating;
• The development of a contact-tracing app which will help the UK adopt best practice in slowing the further spread of the virus.

7. It is imperative that digital and health tech adoption continues not least because social distancing will be the new ‘normal’ for a significant amount of time as society and the NHS continues to limit the spread of the virus. We encourage the Government to continue to fund and adopt such technologies through the implementation and eventual expansion of the MedTech Funding Mandate, amongst other things, and ensure that the Department of Health and Social Care and NHS England works with Clinical Commissioning Groups, Trusts and all relevant parts of the wider health system to harness the benefits of health tech.

The balance between coronavirus and ‘ordinary’ health and care demand  

8. As the NHS slowly places more emphasis on non-COVID 19 care, we encourage NHS leaders both nationally and locally to consider the role that health tech can play in delivering innovation and much needed care. Health tech has demonstrated its vital importance during the pandemic and has an important role to play in tackling waiting lists and supporting individuals with complex health needs. The NHS should also consider how, if at all, the new Nightingale hospitals might use technology to help supplement ordinary care capacity.

Health tech’s role in alleviating pent-up demand

9. A direct consequence of the COVID-19 response has been the delay of a whole swathe of elective care procedures, rising waiting lists and sick individuals who would normally visit A&E avoiding hospitals entirely for fear of contracting the virus, risking otherwise avoidable deaths. It has been suggested that in some cases patients with chest pain are presenting up to 5 days too late at A&E and that individuals have probably died as they have been too frightened to visit hospitals. We therefore recommend that NHS England and Trusts embark on an ongoing public information campaign to ensure patients visit A&E and GPs when they need to.

10. As the NHS plans for elective recovery whilst maintaining COVID-19 capacity, the adoption of health tech across the NHS as outlined in the NHS Long Term Plan must continue. This will ensure both patients and clinicians are protected as well as increasing the capacity of the NHS to recover – particularly staff to work from home or take time off.

11. We foresee several ways health tech can assist:

• In creating more joined up care across currently fragmented primary and secondary care services.
• Providing solutions that remove the need for post-surgical ICU, reduce the length of hospital stay or deliver day case surgery such as minimally invasive surgery reducing overnight stays and allowing other patients to be admitted for care;
• Implantable devices which allow remote monitoring.
• It is worth noting here that the cost-effectiveness of such technologies often results in the provision of more cost-effective care, as highlighted by NICE diagnostic and medical technologies guidance;
• Providing early screening and diagnosis of the most at-risk patients ensuring they receive attention earlier;
• Using AI and machine learning to identify the most at-risk individuals in need of urgent treatment;
• Using AI and machine learning to assist clinicians in the operating room and critical care units;
• Delivering remote monitoring and remote consultations to vulnerable individuals who are self-isolating, which ensures an extra layer of safety through distancing and ensures patients with existing conditions are well supported. These also help to drive care closer to home, whilst supporting clinical governance for busy and overstretched healthcare professionals;
• Delivering remote education opportunities to upskill healthcare professionals;
• Reducing workforce pressures allowing staff to work remotely and assisting with administrative tasks, therefore giving them more time to directly care for patients.

12. It is imperative that discussion on the role of health tech in tackling long waiting lists takes place now, as ‘ordinary’ care is being reinstated in some localities. Given the long waiting lists and huge build-up of demand, even health tech that is only deemed to deliver incremental changes could deliver huge benefits.

13. We fully appreciate that the NHS is facing unprecedented demands and will do so for some time. One of the lessons from this pandemic has been that a focus on unit price and reducing manufacturing costs has led to unintended consequences. As the NHS slowly transitions to focus more and more on ordinary care it is imperative that emphasis should be on care quality and enhancing patient outcomes, linked to patient safety and minimising hospital stay. We believe these should be linked to Key Performance Indicators for all entities that procure in the NHS, especially NHS Supply Chain.

14. We believe there need to be concerted efforts to solve the information governance issues that are often prone to misinterpretation and slow down the adoption of data-enabled services.

15. For medical technologies, devices and diagnostics specifically, the uptake of such technologies needs further prioritisation, especially around the removal of traditional bureaucracy which sometimes stifles progress. The current limitations around health technology appraisals further halts progress and we hope that the Med Tech Funding Mandate helps to streamline innovation and wider payer adoption.

May 2020

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