20 YEARS IN HEALTH TECH
He points out that regulation became increasingly bureaucratic during the past 20 years. This demanded a lot more energy and personnel, and costs increased as a result. 20 years ago, a regulatory department would have had 2-3 people; today it will have 15-20. The HeathTech sector is now seeing innovations that demand different regulatory inputs along with a variety of regulatory overlaps. However, one major factor that has changed the approach to regulation has been driven by COVID, which accelerated the process of collaboration. “We saw a shift, not just around vaccines, but also for ventilators, and PPE to some degree. There was a recognition that innovative products were needed very quickly. As a result, there was a lot of collaboration between many different stakeholders – developers, clinicians, manufacturers, and even those who do not normally manufacture medical devices (such as Airbus, Rolls Royce and Maclaren), as well as the regulatory and conformity assessment bodies. There was a much more integrated approach to how medical devices reached the market. Those lessons are certainly being learnt for future regulatory pathways.
“It is an exciting time for change, and it is moving in a positive direction. We are now seeing outcome-focused, collaborative processes to streamline and speed up pathways. COVID was really transformative,” Brown continues.
Technology adoption It is now 20 years since Sir Derek Wanless described the NHS as ‘a late and slow adopter’ of technology. Trickett points out that one of the issues around technology adoption is that “innovation is everyone’s
Technology is going to have a huge role to play, whether it is digital technologies or genomics, or precision medicines. COVID saw people’s attitudes towards prevention change and all of this builds on a wider societal shift towards being fit and well. COVID has made people more aware of the need to take
care of themselves. Andrew Davies, ABHI, digital health lead
job; therefore, it is nobody’s job.” However, she points out that there have been significant efforts to address the problem over the years. The Accelerated Access Collaborative was established to try and support the adoption and spread of innovation. In 2021/22, the initiative claimed to have provided “over 575,000 patients with access to proven innovations”. Fifteen Academic Health Science Networks (AHSNs) have also been established across England to spread innovation at pace and scale – with the aim of improving health and generating economic growth. Each AHSN works across a distinct geography serving a different population in each region.
NICE has also now appointed a MedTech director and there is increased recognition that more must be done in the non-pharma space, evidenced by DHSC establishing a Medtech Directorate. There has been some significant progress achieved in terms of technology adoption during the past two decades – we have seen advances such as
additives manufacture, artificial intelligence and robotic assisted surgery. Many of these areas have accelerated in recent years,” Jonathan Evans, ABHI’s associate director, communications, points out.“Although many of these advances will have some years to go, before they have a higher level of adoption and spread, technology has come a long way,” he comments. “At the same time, much has stayed the same. We are always going to have a need for wound dressings, surgical scissors, and sutures.” The response to COVID-19 has shown that, with the necessary set of conditions, the NHS can rapidly implement new technologies and ways of working – although digital technology adoption was already underway, enabled by scientific advances in wider society, such as extra computing power and genomics. “This coincided with the wider digitisation
of our everyday lives,” Davies explains. “Healthcare has lagged behind wider society and the acceleration, during the pandemic, has perhaps brought us ‘up to par’. Adoption of innovation has got better, but it is still far from perfect. “There are still too many unnecessary bureaucratic processes, repeated hundreds of times across the NHS,” Davies laments. He believes that the system and culture are not yet “where they need to be”. “There are some great individual organisations, but there is not a systematic approach to using innovation to tackle key health and care issues,” he comments. Going forward, the ABHI is calling for
every NHS organisation to appoint a board level Chief Innovation Officer to share the success of technological innovation, drive clinical and patient enthusiasm, and support required transformational change.
Funding
One of the major changes during the past two decades has been funding: “If you look back to New Labour times, we didn’t have waiting lists because they invested a lot of
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