Volume 2

The use of new medical technologies within the NHS : fifth report of session 2004-05 / House of Commons, Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee.
Date:
2005
Catalogue details

Licence: Open Government Licence

Credit: The use of new medical technologies within the NHS : fifth report of session 2004-05 / House of Commons, Health Committee. Source: Wellcome Collection.

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    4.3 Topics for appraisal are referred to the Institute by the Secretary of State for Health and the Welsh Assembly Government. An appraisal considers the evidence of the health benefits and costs of a health technology. Evidence is considered by the Institute’s independent Appraisal Committee which reaches a judgement as to whether, on balance, the technology can be recommended as a cost-effective use of NHS resources in general, or whether it can be recommended for specific indications or subgroups of patients, if this is more appropriate. 4.4 In reaching this decision, the Institute and the Appraisal Committee take into account the factors listed in the directions of the Secretary of State for Health and the Welsh Assembly Government, namely: 4.4.1 The broad clinical priorities of the Secretary of State for Health and the Welsh Assembly Government (for example, as set out in National Priorities and Planning Framework 2003-06 and in National Service Frameworks, or any specific guidance on individual referrals). 4.4.2 The degree of clinical need of the patients with the condition under consideration. 4.4.3 The broad balance of benefits and costs. 4.4.4 Any guidance from the Secretary of State for Health and Welsh Assembly Government on the resources likely to be available on other such matters as they think fit. 4.4.5 The effective use of available resources. 4.5 The Institute also takes into account the longer-term interests of the NHS in encouraging innovation in technologies that will benefit patients. 4.6 Since January 2002, the NHS has been obliged to provide funding and resources for medicines and treatments recommended by NICE through its technology appraisals work programme. The NHS normally has three months from the date of publication of each technology appraisal guidance to provide funding and resources. Treatment will only be provided if a doctor or nurse, after discussing the options with the patient, thinks that this is the right choice for that patient. INTERVENTIONAL PROCEDURES 4.7 NICE makes recommendations about whether interventional procedures used for diagnosis or treatment are safe enough and work well enough for routine use. An interventional procedure is a procedure used for diagnosis or treatment that involves one of the following: 4.7.1 Making a cut or a hole to gain access to the inside of a patient’s body—for example, when carrying out an operation or inserting a tube into a blood vessel. 4.7.2 Gaining access to a body cavity (such as the digestive system, lungs, womb or bladder) without cutting into the body—for example, examining or carrying out treatment on the inside of the stomach using an instrument inserted via the mouth. 4.7.3 Using electromagnetic energy (which includes X-rays, lasers, gamma-rays and ultraviolet light) or ultrasound—for example, using a laser to treat eye problems. 4.8 Although procedures are most commonly notified by clinicians and other healthcare professionals, any individual or organisation may notify NICE of procedures that are being performed or are likely to be performed within the NHS. Evidence is considered by the independent Interventional Procedures Advisory Committee. NICE issues guidance on interventional procedures to ensure that: 4.8.1 Patients and carers are reassured that new interventional procedures are being monitored and reviewed to protect their safety, and have access to public information about notified procedures. 4.8.2 Clinicians, healthcare organisations and the NHS as a whole will be supported in the process of introducing new procedures. 4.8.3 The Institute can foster innovation by facilitating data collection and analysis, conducting rapid reviews and providing advice on the safety and efficacy of new procedures. 4.9 The programme looks at procedures and not the devices (or drugs) used during the performance of the procedure. Performing an established procedure using a new device would not usually fall within the remit of the programme unless the use of the new device appeared to alter the safety and efficacy profile of the procedure. For the purposes of the programme, NICE considers an interventional procedure to be “new” if a fully trained clinician is considering the use of the procedure/technique for the first time in the NHS outside of a Research Ethics Committee approved protocol. 4.10 The Department of Health has issued a Health Service Circular to the NHS in England explaining what should be considered a new procedure and what process the NHS should follow if a clinician wishes to perform a new procedure. The Welsh Assembly Government and the Scottish Executive have issued similar circulars to the NHS in Wales and Scotland. All three circulars can be found at http://www.nice.org.uk/ page.aspx?0 = 201822.