PROCUREMENT
logical way, to take people through all the things they need to do and give them exam- ples of what they need to do.”
‘Hunger’ for new technology
The structural transformation in the NHS could have its own effect on technology im- plementation, Chisholm suggested.
She said: “We are working with a number of cluster commissioning groups now, be- cause of some of the work we’re doing for the Department of Health, and it’s very interesting to see their hunger for identify- ing solutions that are going to help them improve care, and, of course, align with the QIPP agenda.
“That is perhaps because you’ve got GPs in- volved in that discussion right from the out- set, and they’re much more comfortable with the idea of ‘evidence’ and looking for solu- tions and understanding the pathways their patients follow. But it’s very early days.”
NTAC has a close relationship with NICE and its subsidiary organisations, like the Centre for Health Technology Evaluation.
Chisholm said there have been plenty of examples of useful ‘overlap’ in their work, but added: “We’ve had a number of conver- sations with NICE about how, in an ideal world, we’d like to have a lot more synergy, so that as they are evaluating products and have one likely to be a benefit, we would be able to produce the information and guidance to advise people about how to get those products into use.”
Metrics
Evaluating when it is worth investing to adopt a new technology is an important procedure for NHS organisation, so it’s vi- tal they have the right metrics to be able to do so properly.
Chisholm explained: “Are efficiencies claims made by providers actually correct? That’s where we come in: when we look at technologies, we take that technology and put it into real-time frontline NHS use and collect data and measure what the actual impact is.
“It can be quite a leap of faith for organisa- tions at this point in time. That is another barrier. That said, while you might some- times have a big capital outlay, that isn’t always the case; sometimes it’s actually about just changing a pathway and intro- ducing a different diagnostic, for example.
“At the moment, the pressure for efficiency
savings is very high. The mindset at the moment is that everything must be cash- releasing, because that’s money back in the bank. But, of course, the rationale behind QIPP is dealing with changing demograph- ics, without a huge amount of new invest- ment in the NHS.
“People believe that if something is not cash- releasing, then it’s not worthy of doing. But a key part of QIPP is delivering improved care and meeting the future demand.
“Different organisations have different approaches to metrics, but in terms of in- centivisation, particularly as we are mov- ing increasingly into a market economy, it’s important that organisations deliver outcomes that are comparable to or better than their peers.”
Clearly any such benchmarking, compar- ing organisations or products, can have big financial repercussions for all involved, so it’s important they are accurate.
“IT’S VERY INTERESTING TO SEE THEIR HUNGER FOR IDENTIFYING SOLUTIONS THAT ARE GOING TO HELP THEM IMPROVE CARE, AND, OF COURSE, ALIGN WITH THE QIPP AGENDA.”
A lot to understand
GAP itself had a lot of input from outside NTAC, including NHS organisations and individuals, companies whose products had been through an NTAC adoption pro- cess, and the York Health Economics Con- sortium.
Chisholm said: “The NHS is extraordinar- ily complicated. People don’t understand it – commissioning, providing, purchasing, procurement, supply chain – there’s an at- tempt in here to help people.”
Anyone signing up to use GAP will get a crash course in the way the NHS commis- sions and implements technology, in all its forms, and templates for many of the docu- ments required.
It was publicly-funded, and is freely avail- able for anyone in the NHS – they just need to register and log in to be able to access all the functionality available.
Chisholm said: “We think it’s very positive, but know we need to do more to promote awareness of it, particularly in the NHS.
I would hope that within departments or directorates that have identified a technol- ogy that is going to give them benefits, they would use it to step them through the im- plementation of the adoption process. They would be the people who would be writing the business case, doing the cost analysis and so on.
“There may well be people who are NHS innovators, who are keen to understand more about what they might do with their product. This doesn’t have any reference to finding financial backing, or anything like that, but even within an organisation, getting it accepted, understanding what the measurements are, who’s ultimately going to make the decision – it’s compli- cated. It’s going to come down to the clini- cians, finance people and the people who are making sure the quality of care is as it should be. Technology can improve qual- ity of care, that’s why it’s part of the QIPP programme.”
Industry interest
A PhD student is helping evaluate GAP to give NTAC real feedback on how users are finding it – and clearly the healthcare tech- nology industry has an interest in using all the information and expertise in GAP to help them sell their products. But for peo- ple outside the NHS, a charge applies for the service.
Chisholm explained the rationale: “In the last few months, we have been approached by 40 or 50 providers, usually SMEs but not always, who are struggling at the mo- ment to sell their products.
“Because nobody knows where the NHS is going in terms of funding, we have taken the decision that we have a product and knowl- edge that is a chargeable service. We’re pointing industry people to come and have a conversation with us. We think there’d be added value for them to work with us.”
As NHE was going to press, the NHS inno- vation review led by Sir Ian Carruthers had not yet been published.
Chisholm acknowledged: “There’s an element of pause, just waiting to see what that review produces, and who’s go- ing to be playing which role in the future.”
Sally Chisholm
FOR MORE INFORMATION NHS Technology Adoption Centre T: 0161 200 1620 W:
www.ntac.nhs.uk/GAP/
national health executive Nov/Dec 11 | 83
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