Innovation as a value in healthcare priority-setting: the UK experience

Charlton, Victoria; Rid, Annette

doi:10.1007/s11211-019-00333-9

Cited by 24 publications

(28 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While a particular problem for NHS innovation is the confusing process of implementation, a general issue for healthcare innovation is the process of development. Ranging from early clinical testing through to regulatory approval, the necessary safety and quality checks can represent a substantial barrier for innovators lacking connections and funds [ 93 ]. In this regard, local pathways including the NHS Vanguards and CCG Test Beds schemes have provided an invaluable asset to coordinate testing of innovative MedTech, digital health solutions and care models.…”

Section: Discussionmentioning

confidence: 99%

Innovation Pathways in the NHS: An Introductory Review

Arora

Wright

Cheng

et al. 2021

Ther Innov Regul Sci

View full text Add to dashboard Cite

Healthcare as an industry is recognised as one of the most innovative. Despite heavy regulation, there is substantial scope for new technologies and care models to not only boost patient outcomes but to do so at reduced cost to healthcare systems and consumers. Promoting innovation within national health systems such as the National Health Service (NHS) in the United Kingdom (UK) has been set as a key target for health care professionals and policy makers. However, while the UK has a world-class biomedical research industry, several reports in the last twenty years have highlighted the difficulties faced by the NHS in encouraging and adopting innovations, with the journey from idea to implementation of health technology often taking years and being very expensive, with a high failure rate. This has led to the establishment of several innovation pathways within and around the NHS, to encourage the invention, development and implementation of cost-effective technologies that improve health care delivery. These pathways span local, regional and national health infrastructure. They operate at different stages of the innovation pipeline, with their scope and work defined by location, technology area or industry sector, based on the specific problem identified when they were set up. In this introductory review, we outline each of the major innovation pathways operating at local, regional and national levels across the NHS, including their history, governance, operating procedures and areas of expertise. The extent to which innovation pathways address current challenges faced by innovators is discussed, as well as areas for improvement and future study.

show abstract

Section: Discussionmentioning

confidence: 99%

Innovation Pathways in the NHS: An Introductory Review

Arora

Wright

Cheng

et al. 2021

Ther Innov Regul Sci

View full text Add to dashboard Cite

show abstract

“…Taking into account the far-reaching effect of health interventions on society is recognized to be a crucial aspect of the overall methodological quality of economic evaluations (18), as well as an important factor in national decision making (19). In line with previous research, the current study demonstrates that mental health problems have an (economic) effect on a wide range of sectors in society, including the education sector (3;15).…”

Section: Discussionmentioning

confidence: 99%

Exploring the identification, validation, and categorization of costs and benefits of education in mental health: The PECUNIA project

Pokhilenko

Janssen

Evers

et al. 2020

Int J Technol Assess Health Care

View full text Add to dashboard Cite

Background Mental health problems can lead to costs and benefits in other sectors (e.g. in the education sector) in addition to the healthcare sector. These related costs and benefits are known as intersectoral costs and benefits (ICBs). Although some ICBs within the education sector have been identified previously, little is known about their extensiveness and transferability, which is crucial for their inclusion in health economics research. Objectives The aim of this study was to identify ICBs in the education sector, to validate the list of ICBs in a broader European context, and to categorize the ICBs using mental health as a case study. Methods Previously identified ICBs in the education sector were used as a basis for this study. Additional ICBs were extracted from peer-reviewed literature in PubMed and grey literature from six European countries. A comprehensive list of unique items was developed based on the identified ICBs. The list was validated by surveying an international group of educational experts. The survey results were used to finalize the list, which was categorized according to the care atom. Results Additional ICBs in the education sector were retrieved from ninety-six sources. Fourteen experts from six European countries assessed the list for completeness, clarity, and relevance. The final list contained twenty-four ICBs categorized into input, throughput, and output. Conclusion By providing a comprehensive list of ICBs in the education sector, this study laid further foundations for the inclusion of important societal costs in health economics research in the broader European context.

show abstract

“…They are insensitive to potentially relevant differences within these criteria—for instance, a technology that offers a 3-month extension to life is treated the same as one that extends life by 5 years—and they limit committees’ freedom to consider other potentially relevant factors, such as the age of those concerned. The relevance of some of these formal criteria can also be questioned, with population studies and deliberations of NICE’s CC suggesting that fair-minded people might not support some of the values on which these rules are based [ 10 , 30 , 53 , 54 , 56 , 72 ].…”

Section: Discussionmentioning

confidence: 99%

NICE and Fair? Health Technology Assessment Policy Under the UK’s National Institute for Health and Care Excellence, 1999–2018

Charlton

2019

Health Care Anal

Self Cite

View full text Add to dashboard Cite

The UK’s National Institute for Health and Care Excellence (NICE) is responsible for conducting health technology assessment (HTA) on behalf of the National Health Service (NHS). In seeking to justify its recommendations to the NHS about which technologies to fund, NICE claims to adopt two complementary ethical frameworks, one procedural—accountability for reasonableness (AfR)—and one substantive—an ‘ethics of opportunity costs’ (EOC) that rests primarily on the notion of allocative efficiency. This study is the first to empirically examine normative changes to NICE’s approach and to analyse whether these enhance or diminish the fairness of its decision-making, as judged against these frameworks. It finds that increasing formalisation of NICE’s approach and a weakening of the burden of proof laid on technologies undergoing HTA have together undermined its commitment to EOC. This implies a loss of allocative efficiency and a shift in the balance of how the interests of different NHS users are served, in favour of those who benefit directly from NICE’s recommendations. These changes also weaken NICE’s commitment to AfR by diminishing the publicity of its decision-making and by encouraging the adoption of rationales that cannot easily be shown to meet the relevance condition. This signals a need for either substantial reform of NICE’s approach, or more accurate communication of the ethical reasoning on which it is based. The study also highlights the need for further empirical work to explore the impact of these policy changes on NICE’s practice of HTA and to better understand how and why they have come about.

show abstract

Innovation as a value in healthcare priority-setting: the UK experience

Cited by 24 publications

References 33 publications

Innovation Pathways in the NHS: An Introductory Review

Innovation Pathways in the NHS: An Introductory Review

Exploring the identification, validation, and categorization of costs and benefits of education in mental health: The PECUNIA project

NICE and Fair? Health Technology Assessment Policy Under the UK’s National Institute for Health and Care Excellence, 1999–2018

Contact Info

Product

Resources

About