1. Health Technologies Adoption Programme Stephen Hodges – Technology Implementation Manager

2. Where HTAP came from NTAC 2007 Set up by Department of Health to identify barriers to technology adoption Based in Manchester, worked across UK Technologies identified by calls to the NHS and industry, over time increasing joint work with NICE How2Why2 Guides Commercial support to industry

3. How NTAC arrived at NICE Innovation, Health and Wealth (2011) Accelerating adoption and diffusion in the NHS o Sunset Review Recommended transfer to NICE Memorandum of understanding with NHS England

4. Skills & experience within the team All team clinically qualified Primary, acute, mental health and social care experience Commissioners, providers, management (community and acute), strategic service planning, service redesign Health visiting, child protection, research, clinical risk and complaints, patient involvement

5. HTAP Objectives Assess the factors that will promote access to and increase the uptake of NICE guidance (MTEP/DAP/TA) Establish an agreed approach for NICE to develop effective partnerships with AHSNs To support the expansion of the medical technologies industry in the UK by providing advice to suppliers

6. Test Medical Technologies Evaluation Programme (MTEP) Diagnostics Assessment Programme (DAP) Technology Appraisals (TA) Manufacturers notify topics to NICE Device

7. MTAC MTEP DAP Guidance HTAP Adoption Support Retrospective Prospective Adoption Support Retrospective Prospective Med Tech Company Publication Advisory Consultation meeting Advisory Consultation meeting Clinical associates Selection process

8. How does HTAP work? Resources aligned to NICE Guidance Technology in use in the NHS - demonstrator projects Technology in use in the NHS, less common & more complex - adoption projects

11. Example… Availability Although most operating theatres and intensive care units have access to fibre optic endoscopes, common situations which might reduce this availability include: The requirement to sterilise multiple use endoscopes after every use and every 72 hours when not used. This is commonly carried out in a central endoscope processing unit and will remove the endoscope from use for a number of hours. Use of an endoscope out of routine working hours, such as during the night or when the processing unit is closed, may result in the equipment being removed from service for up to 2 days. The need for multiple use endoscopes to be regularly maintained and on occasion repaired.

12. Practical Examples Workforce considerations Staffing Whilst visiting NHS sites to discuss the use of Ambu aScope2, HTAP found that the impact of implementation upon staffing is minimal. The Ambu aScope2 does not introduce any new clinical techniques, move the setting of care or impact upon current role boundaries. Training Training staff to use the Ambu aScope2 is initially undertaken by the manufacturer. Ambu have a Training Specialist in Airway Visualisation who offers bespoke training to NHS sites. Training may then be disseminated within a department with an anaesthetist or senior ODP usually taking the lead.

13. Benefits reported by Trusts Improved safety – having access to an endoscope immediately at the point of need. Reduced likelihood of re-scheduling of surgery Ease of use in the hands of a skilled operator – does not require a new skill set to be learned. Easy to transport to the point of use. Endoscopes are packaged sterile and are single patient use so do not need to be disinfected prior to or following use. No need for repairs or maintenance – the Ambu aScope2 is disposable. If it gets damaged during a procedure, this will have no major clinical or financial consequences in terms of endoscope unavailability or repair costs.

14. Common adoption hurdles Financing – capital and revenue Pathway re-design Clinical utility Decommissioning Role expansion Education Realising efficiencies

15. So what are the critical adoption success factors? How to plan and support the process of adoption –Local decision making processes –Clinical and Managerial Champions –Local strategies/priorities How the pathway changes –Current care pathway & service delivery models –Avoidance of hospital attendance –Offering faster access to a diagnosis

16. …so what are the critical adoption success factors? Understand quality –Training, competence, safe environment Business case –Local business case process –Capital & revenue, efficiencies and outcomes Data –Baseline & change

17. Commercial offering… SAP Support the medical technologies industry by providing bespoke adoption advice to manufacturers and suppliers HTAP reference panel Adoption clinics

18. Contact details Jae Long nice.htap@nhs.net nice.org.uk