deja review - medical technology group · improving the way the nhs uses innovation has become the...

DEJA REVIEW: What lessons can be learnt from the past?

www.mtg.org.uk

Contents

4 Overview of Recommendations

5 Introduction

6 Chapter 1: Assessing IHW and Shaping the AAR

10 Chapter 2: Lessons Learnt from Past Initiatives

13 Chapter 3: Avoiding the Mistakes of the Past

16 Conclusion

17 References

18 Abbreviations

19 About e Medical Technology Group


Overview of recommendations

1e MTG has concerns that the AAR team are not learning the lessons from previousinitiatives and building those into their work programme. We recommend that the AAR team works with architects of the IHW programme to assess how implementation could have been improved and factor these in.

2 e delivery of the AAR should support the implementation of the Five Year Forward View.Other overlapping initiatives, such as the Carter Review, should work alongside the AAR.is will improve accountability and proper implementation.

3e MTG believes that the AAR should focus on system wide adoption of technology that looks at cultural, structural and organisational barriers. Focussing on specific products and technologies is unlikely to achieve the level of impact needed to make real changes across the healthcare system.

4 e MTG believes NHS England and the Department of Health should work together to clarify the status of IHW and to include any of the ongoing work programmes under the AAR workstreams

5e MTG recommends that NHS England and the Department of Health maintain a longterm commitment to the AAR programme. It is highly unlikely that the measures in thereport will have an impact in year one, which is something policy makers should be aware of when developing ideas.

6 e MTG believes that the Academic Health Science Networks (AHSNs) should play a centralrole in supporting the spread of innovative technologies across the NHS. e AHSNs shouldbe given the funding and support they need to deliver the AAR recommendations.

7e MTG believes that patient outcomes should be measured against the use of evidence and unacceptable variation should be targeted. is benchmarking should be applied locally and regionally. e AAR should make NHS inspection regimes address the uptake of innovation.

8e MTG recommends that the AAR makes changes to the current NHS budget system and allow healthcare providers to invest in innovative technology, where the return oninvestment will not come in year one. is should take the form of a special fund forlarge scale investment and subsequent service reorganisation.

9 e MTG would like to see a clear plan for how each and every measure or recommendationcontained in the AAR will be implemented. ere should be detailed work programmes, with appropriate resources, to ensure that all aspects of the report become a reality.

Introduction

Improving the way the NHS uses innovation hasbecome the holy grail of NHS efficiency. In 2004,Dereck Wanless described the NHS as a ‘late and slowadopter of innovation’ in his review, ‘Securing GoodHealth for the Whole Population’. 12 years on sincethat report and many people would argue that thesituation remains the same, despite a series ofinitiatives and reports promoting better use ofinnovation.

e Accelerated Access Review (AAR) will soon bepublished and with it we will see a range of newmeasures aimed at addressing an old problem. In thisreport the Medical Technology Group (MTG) willlook at what can be learnt from previous initiativesand suggest ways the Accelerated Access Review(AAR) can have most impact. A clear focus will be onthe most recent initiative - the Innovation, Health and

Wealth Report published in 2011, looking at thereasons this did not have the impact that wasexpected.

We also set out the measures we think are necessaryfor the AAR to have a lasting impact on the NHS’ useof innovative technology and the areas we believe theAAR should focus.

Areas the AAR should focus on:

► Learn from previous innovation reports

► Commit to a long term programme

► Application of the available evidence

► Breakdown budgetary barriers and incentiviseinnovation

► Focus on implementation


Chapter 1: Assessing IHW and Shaping the AAR

Following the publication of the interim AAR reportin October 2015, the RAND Group published a reviewof the key recommendations in March 2016. esewere:

► A new earmarked fund to encourage AHSNs andother key innovation factors to lead systemredesign to embrace innovation and the adoptionof evidence-based, high impact innovations.

► Mobilising the influence of clinical system leadersto champion change.

► Encouraging secondary care organisations to takeon ‘innovation champion’ roles linked to financialincentives and a new emphasis on accountablecare organisations.

Compare and contrast AAR and IHW

e IHW report contained over 30 individualrecommendations. ese ranged from measures suchas establishing additional NHS infrastructure (theAcademic Health Science Networks), to promotingindividual technologies such as intraoperative fluidmanagement.

e themes for IHW were as follows:

► Reducing variation and strengthening compliance

► Metrics and information

► Creating a system for delivery of innovation

► Incentives and investment

► Procurement

► Developing our people

► Leadership for innovation

► High impact innovation

e AAR Interim Report sets out four propositions,or key themes:

► putting the patient at centre stage: a call forpatients to be given a stronger voice at every stageof the innovation pathway

► getting ahead of the curve: a new approach toaccelerating the process for products entering thehealth system

► supporting all innovators: ensuring the acceleratedaccess pathway is more responsive to the widerpool of innovation available

► galvanising the NHS: ensuring the NHS isincentivised to adopt new products

Figure 2. shows the main areas that innovationpromotion generally falls into and where the IHWreport and interim AAR have focussed.

e four areas are:

► Infrastructure and payment mechanisms: thedevelopment of additional organisations andbodies responsible for the promotion ofinnovation. Historically these have tended to beNHS organisations but they have not beenembedded within NHS delivery structures.Payment mechanisms refers to the variousattempts at incentivising innovation through thecreation of additional payments or penalisingthose who fail to adopt.

► People: Developing a culture of innovationthroughout the NHS will require all NHS staff toprioritise it. is includes those on the frontlineand NHS managers at all levels. Several initiativeshave been aimed at achieving this.

► Products: Focussing on individual products andincentivising them. is is generally aimed atproven technologies with a well-developedevidence base and seeks to push NHS institutionstowards those products.

► Procurement and HTA: encouraging providers touse technology by breaking down technicalbarriers. ese generally fall into two areas -procurement functions and health technologyassessment. e objectives and priorities ofprocurement teams are oen not aligned to thoseof clinical teams. Focussing on procurementprioritisation will help break down barriers. Highquality evidence should underpin the use of anytechnology, but how the evidence is gathered,interpreted, assessed and ultimately used holds the

key to better uptake. Many mechanisms have focussedon evidence development and promotion.

As figure 2. demonstrates, many of themes and areasof focus for IHW were weighted towards individualproducts and procurement and HTA. e themes forthe AAR interim report are evenly spread across threeareas, avoiding the prioritisation of individualproducts.

Infrastructure and PaymentMechanisms

Product

People

Procurementand HTA

Getting Ahead of the Curve

Galvanisingthe NHS

Putting the Patientat Centre Stage

Leadership forinnovation

Creating a systemfor delivery of

innovation

Developing our people

High impactinnovation

Metrics andinformation

Procurement

Reducing variationand strengthening

compliance Incentives andinvestment

Supporting all innovators

Figure 2

e MTG analysed the key areas of focus for the Innovation Health and Wealth reportand what we have seen from the Accelerated Access Review. e majority of outputsfrom IHW were focussed on individual products or procurement and HTA.


What we’ve seen

› › › › › › 2005 2006 2007 2008 2009 20

Nowdefunct

Still inexistence

HITF e Darzi Review of NHS

Commissionin

Minister

NHS Institute for Innovation and Impr

National Technolo

Health Inno

Nat

› › › › › › 010 2011 2012 2013 2014 2015

Innovation Health and Wealth

IHW - 1 Year On

AAR Interim

CtE

AHSNs

Regional Innovation Fund

NHS Innovation Challenge Prizes

Innovation Scorecard

MTAC/MTEPNHS Innovation Expo

SBRI

Innovation Hubs

g for Quality and Innovation (CQUIN) payment framework

rial Medical Technology Strategy Group

rovement

ogy Adoption Centre

ovation Centre

tional Innovation Centre

High Impact Innovations

iTAPP

Figure 1

e MTG carried out research into the organisations and initiativesthat have been launched by the NHS or the Government to supportthe uptake of innovation. We identified 17 different organisationsor initiatives, six of which are now shut.


Chapter 2: Lessons Learnt from Past Initiatives

In order for the AAR to be successful it will need tolook at the successes and failures of previousinnovation reports and look to build on the positivesand eliminate the negatives. e AAR teamcommissioned RAND Europe, a not for profit policyresearch organisation to assess the success of the mostrecent innovation report - Innovation Health andWealth (IHW). RAND assessed the report andconducted a series of interviews to ascertain whatstakeholders felt the impact of IHW had been.

RAND make a number of key points on IHW. On theoverall strategy they point out that it was an ambitiousand innovative strategy in itself. ey do however,point out that stakeholders felt that the overallevolution of IHW has not been ‘informed by an overallstrategic sense of direction’. It was believed there hasbeen a lack of ‘cross referencing between actions’. Assome initiatives have developed - InnovationTechnology Adoption Programme becoming NICETechnology Evaluation Programme, for example theyhave not referenced IHW. To many NHS professionalsit is not clear whether they are even part of IHW or ifthe new initiative is a continuation of the old, or evensomething completely new.

It is also clear to those involved that IHW lackedconnectivity with other reports and initiatives that havecome since. It is not clear how IHW will feed into theAAR review. Issues were also raised around thetransparency and accountability of IHW. Informationand data was not stored and assessed centrally so it isnot clear how implementation is measured. Issues suchas metrics to measure innovation uptake are yet to berolled out.

IHW is thought to have helped support some positive

cultural change across the NHS. ere was, however,a general feeling that NHS frontline staff should haveto prioritise the development of local wealth alongsidehealthcare delivery.

Overall the RAND report paints a mixed picture of thesuccess of IHW. Whilst there is acknowledgement ofsuccess in certain areas, there is a general lack ofawareness and a level of uncertainty around theongoing work in certain areas. Whilst IHW has neverbeen definitively closed and certain initiatives continue- AHSNs and CQUINs for example - it is difficult to seea concerted set of activity around IHW that could bedescribed as a ‘strategy and work programme’.

Is AAR connecting with the IHW team?

In order to ascertain this the MTG, working with MPs,put down a number of Parliamentary Questions.Working with Andrew Gwynne MP, we asked: “Whatlessons have been learned from the implementation ofrecommendations contained in NHS England's report,entitled Innovation, Health and Wealth, published inDecember 2011; and how his Department isimplementing those lessons in the Accelerated AccessReview.”

George Freeman the Parliamentary Under-Secretaryof State for Business, Innovation and Skills, eParliamentary Under-Secretary of State for Health gavethe following response: “Innovation Health and Wealthrightly emphasised how crucial innovation is to ourbetter care for patients and improving the health andcare system. e Accelerated Access Review wasestablished to build on this, recognising the fundamentalcontribution that the United Kingdom’s world class

“e definition of insanity is doing something over and over again and expecting a different result.”

- Oen misattributed to Albert Einstein

medical innovators make to our economy. eevaluation of the Innovation, Health and Wealth hasformed part of the review evidence base.

e independent Accelerated Access Review will report atthe end of April with recommendations on how to increasethe uptake of innovation in the National Health Service.”

We also posed a number of questions around theassessment of IHW and how the lessons learnt fromthat have been taken forward to AAR. For eachquestion we received the following response fromGeorge Freeman: “e Department is funding RANDEurope and the University of Manchester to conduct aformative and summative evaluation of Innovation,Health and Wealth (IHW). e project is expected tocomplete in 2017 and the report on the first stage of theevaluation, including an assessment of progress towardsactions within eme 8: High Impact Innovations, canbe found on the RAND Europe website:www.rand.org/pubs/research_reports/RR1143.html

“is report represents the first phase of a three yearevaluation aimed at mapping progress towards the IHWstrategy and its component actions. e Department willbe considering the outputs of the evaluation as theyemerge over the next three years including as part of theevidence feeding into the Accelerated Access Review.”

Can the AAR provide a joined up solution?

Alongside the learnings from previous reports the AARmust focus on bringing a number of reports, initiatives

and work streams together and becoming the deliveryvehicle for them when it comes to innovation adoption.

In October 2014 NHS England published the NHSFive Year Forward View, a report that detailed NHSpriorities and strategy for the next five years. e FiveYear Forward View contains a whole section ontechnology entitled, “We will accelerate useful healthinnovation”. is section contains a number ofmeasures around expanding NICE capacity to devicesand improving the time it takes from discovery toclinical practice.

e areas of focus in the Five Year Forward View willhave huge overlap with AAR. Where there issignificant crossover it is important that there is clearownership and accountability. ere is a clear threat ofduplication of effort as a result of multiple programmesthat overlap in output and purpose. Where thishappens the delivery team for the AAR should be givenclear responsibility for the outcome of the work.

In recent months we have also seen the ‘Operationalproductivity and performance in English NHS acutehospitals: Unwarranted variations’ from Lord Carter.Whilst this report was aimed at promoting NHSefficiency and avoiding unnecessary cost, it will have asignificant impact on how innovative treatments arepurchased and used.

e report focuses on various aspects of NHSefficiency, in particular procurement. e reporthighlights the use of a number of different products -“Although a lot of effort has been put in at trust level tomanage key clinical categories such as cardiac stents, thesupply base and product offering has steadily increasedin fragmentation and variety”.

Whilst the MTG fully supports the NHS’ drive toimprove efficiency, there is a danger that this will beginto impact patient experience. Clinical choice is a keyelement of delivering high quality outcomes andensuring long-term cost reduction by removing theneed to treat patients a second time. Limiting thischoice could well harm this process and lead toincreased costs later down the line.

e AAR and Efficiency Review work programmesshould go hand-in-hand. We must keep the patient atthe heart of any activity. Driving efficiency should be

e MTG has concerns that the AAR team are not learning thelessons from previous initiatives and building those into their workprogramme. We recommend that theAAR team works with architects ofthe IHW programme to assess howimplementation could have beenimproved and factor these in.


done to ensure more patients can be treated andencouraging innovation into the system should be doneas efficiently as possible. Ensuring mutual cooperationwould help deliver success for both programmes.

Avoid focussing on individual technologies

In 2015 the MTG carried out research to assess howwell the ‘High Impact Innovations’ (HIIs) programmecontained in IHW had been implemented. e MTGsent Freedom of Information requests to all trusts tolook at how they were doing with implementation.

e six high impact innovations were: accelerate theuse of assistive technology; full implementation ofOesophageal Doppler Monitoring; launch ‘Child in aChair in a Day’; require NHS organisations to exploreopportunities to increase national and internationalhealthcare activity; digital by default - reducinginappropriate face-to-face contact and better supportfor carers.

e MTG’s assessment of the impact of these measuresfound a distinctly mixed picture across the UK. Somemeasures had been implemented well in certain areasand some had been ignored. e RAND report foundthat only 13% of people they spoke to thought the HIIsprogramme was working well as an action.

Judging by the results of the HIIs programme it is clearthat neither NHS England nor the Department ofHealth will be able to ‘pick winners’ in terms of theindividual technology or initiatives. As recommendedin our report in 2015, we would avoid this approach.

e delivery of the AAR shouldsupport the implementation of theFive Year Forward View. Otheroverlapping initiatives, such as the Carter Review, should workalongside the AAR. is willimprove accountability andimplementation.

e MTG believes that the AARshould focus on system wideadoption of technology that looks atcultural, structural andorganisational barriers. Focussingon specific products and technologiesis unlikely to achieve the level ofimpact needed to make real changes across the healthcare system.

Chapter 3: Avoiding the Mistakes of the Past

e current challenges facing the NHS are welldocumented - the £30bn black hole by 2020. Mostcommentators agree that there is no quick fix to thisproblem and the solution lies in changing the waypeople live their lives as well as the way we deliver care.Plugging this gap will not come by reducing patientaccess or adjusting delivery in a few areas. efundamentals of how the NHS are structured need tobe addressed - the system was established anddesigned to treat short spells of ill health rather thanlook aer populations with multiple, complicated anddebilitating long term chronic conditions.

Addressing this challenge will require the NHS to getthe best out of the available technology. atinnovation plays an important role in the solution iswidely acknowledged by commentators. It is alsogenerally agreed that the NHS does not always get thebest out of technology and oen fails to harness thepotential on offer.

e AAR was established to harness the benefits ofinnovation to help drive NHS efficiency. When thereview was established the following benefits were setout:-

► patients will have access to, and be treated with,cutting-edge medical products sooner

► research organisations, patient groups andcharities will be able to be an integral part of theprocess for developing new products from theoutset

► clinicians will be able to support their patients toaccess more effective and affordable innovativetreatments and achieve better health

► businesses will benefit as a result of a simpler,better and more joined up development pathwayfor medicines, devices and digital healthcare

► stimulation of new investment, jobs and economicgrowth to support the NHS

e review was set to look at three key areas -regulation, reimbursement and uptake. e MTG

supports the benefits outlined and the areas the reviewis seeking to address. Here the MTG sets out thecritical factors that will impact how successful thereview is.

Take lessons from past initiatives

As set out above it is important that the AAR looks atwhat has worked and what has failed through pastinnovation supporting initiatives. ere have been anumber of reports and work programmes aimed ataddressing this issue, yet few have lasted more than afew short years before being transformed intosomething else or simply ceasing to exist.

e RAND review for NHS England highlights this -‘is document found the current status of IHW is notclear. None of the websites searched allowed us toconfirm with certainty that the IHW strategy isongoing’.

Give the AAR the time and support it needs

IHW was launched with much fanfare and energy byNHS England. e report was meant to set out a seriesof activities that would form the basis of theinnovation support for years to come. In the Strategyfor UK Life Sciences there is an explicit call for theorganisation in charge of the IHW strategy, theLifesciences Advisory Board, to produce an annual

e MTG believes NHS Englandand the Department of Healthshould work together to clarify thestatus of IHW and to include any of the ongoing work programmesunder the AAR workstreams.


report detailing progress - “e Advisory Board willreport back on progress via a formal annual report toRt. Hon. David Willetts MP (Minister of State forUniversities and Science) and Rt. Hon. Andrew LansleyCBE MP (Secretary of State of Health). e report willalso be submitted to the Prime Minister and madeavailable publicly.”

e original IHW report was the first of these annualpublications. e Department of Health was able todeliver a second report, published December 2012.is report took the form of a review of IHW, one yearon. e RAND report points out that NHS Englandhad committed to the IHW refresh, but that there wasno evidence available to point to this still being thecase. Since then there have not been any updates orclarity on the status of IHW.

Develop a single system for improving innovation uptake

As pointed out by the Association of BritishHealthcare Industries (ABHI) in their 2015 manifesto,a top down, centralised approach to spreadinginnovation and best practice is unlikely to besuccessful and has been tried a number of times in thepast. e ABHI recommends that NHS Englanddefine a single process for the dissemination ofinnovation.

e AAR should also define the delivery vehicle fortheir initiatives. Previous reports and measures havesought to develop additional infrastructure within the

NHS. ese have had mixed success. e MTG doesnot believe that the AAR should seek to develop neworganisations within the NHS, but should look toenhance the organisations already in place - mostnotably the Academic Health Science Networks(AHSNs).

e establishment of national organisations that sitoutside of traditional NHS delivery structures isunlikely to be successful - as developing a system inthis style is unlikely to engage NHS staff. Engagingfrontline NHS teams, the very people who will beusing innovative technology and techniques, is criticalto successful implementation. is process will besupported through infrastructure that is part of theNHS, well established and well regarded by thosedelivering care.

Trust the data

Many technologies that are underused across the NHScome with a huge range of data and evidence tosupport their efficacy. A central element of the AARshould be ensuring that these technologies are usedacross the system.

e MTG has published a number of reports that lookat the use of proven technologies- insulin pumps, hipand knee replacement amongst others. e reportshave found the NHS to only be consistent in itsinconsistency. Patient access to insulin pumps haslong lagged behind the NICE recommended level of12% - despite the guidance first being published in2003. In 2010 the MTG found the level was 3.9%. Forhip and knee replacement we found that the time of

e MTG recommends that NHSEngland and the Department ofHealth maintain a long termcommitment to the AARprogramme. It is highly unlikelythat the measures in the report willhave an impact in year one, whichis something policy makers shouldbe aware of when developing ideas.

e MTG believes that the AHSNs should play a central role in supporting the spread ofinnovative technologies across theNHS. e AHSNs should be giventhe funding and support they need to deliver the AARrecommendations.

year you present to hospital has a huge impact on thespeed with which you get treated.

A key area of focus for the AAR should be to ensurethat NHS organisations are applying the relevantevidence when making healthcare decisions.

From barriers to incentives

e payment systems and budgeting cycles within theNHS do not always incentivise innovation. Asdescribed by the ABHI ‘these barriers are significantand persistent’. Annual budgetary cycles and budgetsilos mean that investment in new approaches is oenlimited as you will not realise the benefit within thisbudgetary cycle or in your own budgetary silo.

For example, minimally invasive surgery can savecosts by getting patients out of hospital quicker. ecost of the improved technology, however, falls on theoperating theatre budget. e savings are realised onthe general ward, which removes the incentive for thetheatre team to make the investment.

e AAR must acknowledge the limitations of thissystem and put in place a number of measures thatwill support organisations to make wholesale changesto delivery that might not return an investment in yearone.

Focus on implementation

e RAND report assessed how well IHW had beenimplemented and found a mixed picture - ‘edocument review found that while some actions havebeen completed and others are underway, many do notappear to have been implemented at all’.

Setting out recommendations that then fail to gain anytraction or even have the process of implementationstarted undermines the general support for the overallwork programme. It can also have a negative impacton other areas as people question why certainelements are not being rolled out.

MTG believes that patientoutcomes should be measuredagainst the use of evidence andunacceptable variation should betargeted. is benchmarkingshould be applied locally andregionally. AAR should make NHSinspection regimes address theuptake of innovation.

e MTG recommends that the AARmakes changes to the current NHSbudget system and allow healthcareproviders to invest in innovativetechnology where the return oninvestment will not come in yearone. is should take the form of aspecial fund for large scaleinvestment and subsequent servicereorganisation.

e MTG would like to see a clearplan for how each and everymeasure or recommendationcontained in the AAR will beimplemented. ere should bedetailed work programmes, withappropriate resources, to ensurethat all aspects of the reportbecome a reality.


Conclusion

Whilst issues around innovation uptake and use across the NHS havebeen around for several years, they are not insurmountable. e AARrepresents a real opportunity to address these issues and make a realdifference for the future.

A key element of addressing issues around innovation uptake will befrom learning the mistakes of the past.

e MTG believe the AAR team should then focus on the key areas setout below:

► Learn from previous innovation reports

► Commit to a long term programme

► Application of the available evidence

► Breakdown budgetary barriers and incentivise innovation

Following the development of a comprehensive work programme thework should place a relentless focus on implementation and impact.Many previous strategies may not have failed as a result of being poorlyplanned, but because they didn’t receive the appropriate support duringthe implementation phase.

References

Innovation, Health and Wealth Reportwww.institute.nhs.uk/images/documents/Innovation/Innovation%20Health%20and%20Wealth%20-%20accelerating%20adoption%20and%20diffusion%20in%20the%20NHS.pdf

Evaluating the role and contribution of innovation to health and wealth in the UK, A review of Innovation, Health and Wealth: Phase 1 Final Reportwww.rand.org/pubs/research_reports/RR1143.html

MTG Innovation Health and Wealth – A Scorecard Reportdrive.google.com/file/d/0B60cHNIWGkbid3hyV3RMM0x6Mjg/view

Accelerated Access Review: Interim Reportwww.gov.uk/government/uploads/system/uploads/attachment_data/file/471562/AAR_Interim_Report_acc.pdf


Abbreviations

MTG e Medical Technology Group

CtE Commissioning through Evaluation

AHSNs Academic Health Science Networks

MTAC/MTEP e Medical Technologies Advisory Committee/e NICE Medical Technologies Evaluation Programme

SBRI Small Business Research Initiative for Healthcare

CQUIN Commissioning for Quality and Innovation

iTAPP Innovative Technology Adoption Procurement Programme

ABHI Association of British Healthcare Industries

AAR Accelerated Access Review

IHW Innovation, Health and Wealth Report

HTA Health Technology Assessment

HIIs High Impact Innovations

HITF Health Care Interpretations Task Force

e Medical Technology Group (MTG) is the onlyUK coalition of patient group charities, medicaltechnology and life sciences companies workingtogether to improve patient access to medicaltechnologies.

e common purpose of the MTG is to increasepatient access to the best diagnostic, imaging, surgicaland supported-living technologies on the NHS.

Appropriate use of medical technology provides valuefor money to the NHS, patients and taxpayers. It canimprove clinical outcomes and experiences ofpatients and supports the wellbeing and personaldevelopment of individuals. It can also help to achievesavings to the NHS and other areas of publicspending in a tight budgetary climate by improvingindependence, supporting care closer to home, andenabling faster rehabilitation aer surgery as just afew examples.

Patient access to proven medical technology is not asgood as it should be in the UK. Mainstreamingmedical technology is an important part of the qualityand efficiency agenda for today’s NHS.

We need to foster a culture of improvement in theNHS so that:

■ patients are empowered to access the technologythat could help them to manage their conditionand get on with their lives;

■ commissioners are equipped to plan and deliverservices that address growing patient need costeffectively;

■ clinicians can harness technologies wherever it canbest support the outcomes and experiences of thepatient.

About e Medical Technology Group

MTG Membership

ABHIAdvaMedAntiCoagulation EuropeARMAArrhythmia AllianceArthritis CareAtrial Fibrillation AssociationBDBritish Kidney Patient AssociationBladder and Bowel FoundationBoston ScientificBritish Cardiac Patients AssociationC R BardCardiomyopathy UKDiabetes UKEdwards LifesciencesEucomedFABLEFEmISAGroup B Strep SupportHeart Research UKHeart Valve VoiceICD GroupINPUTInsightecInternational Alliance of Patients' OrganizationsJDRFJohnson & JohnsonLindsay Leg ClubMedtronicNational Rheumatoid Arthritis SocietyPancreatic Cancer UKPelvic Pain Support NetworkPumping MarvellousRoche DiagnosticsSADS UKSmith & NephewSmiths MedicalSt Jude MedicalSTARSStrykere Circulation Foundatione Patients Associatione Somerville Foundation

www.mtg.org.uk

deja review - medical technology group · improving the way the nhs uses innovation has become the...

Documents