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Accelerated Access Report should not rush to a standstill

Sir Hugh Taylor’s much-anticipated NHS review, the Accelerated Access Report of Innovative Medicines and Medical Technologies (AAR), has been published.

Foremost amongst its recommendations, and critical to the report’s success, is the challenge to NHS managers to focus on creating or supporting processes that will speedily and easily enable frontline commissioners and prescribers across the NHS to prioritise innovative patient solutions.

The Medical Technology Group welcomes the report, and applauds the Expert Advisory Group both in its general approach, and in particular for evolving the 2011 Innovation, Health and Wealth (IHW) report’s focus on individual treatment products into a more broadly based ‘genre’ approach that allows for increased personalisation of treatments by clinicians .  The MTG believes that this change can help deliver an improved sense of strategic direction to the NHS and facilitate better cross-referencing of knowledge and experiences across the organisation and its stakeholder bodies.

However, the MTG notes with a heightened sense of regret that the NHS has historically and consistently failed to apply any learning from previous reviews such as the IHW, and that a change of cultural mind-set within the NHS is required if AAR is to have any impact where it matters, on patients.  We want to encourage the adoption of an attitude that is welcoming and enquiring of innovation and the benefits technologies can offer to patients, and which can ultimately reduce strain on budgets by supporting innovative technologies that may have high up-front costs but which ultimately deliver reduced related costs, including expensive hospital days and evolving co-morbidities that could have been avoided.

The MTG believes that this learning already exists within the NHS and that if it were to apply it across its existing integrated networks – such as NHS England’s Academic Health Science Networks – then the momentum generated by the publication of the AAR could result in real organisational cohesion, and sustainable legacy for the NHS and improved outcomes for many patients who are being failed by the current innovation inertia.

The Accelerated Access Report is just one of almost 20 reports and reviews into innovation in the NHS over the past ten years. If the NHS is sincere in its desire to address the fundamental challenges around patient access to treatment it needs to address fundamental internal issues including its general attitude towards technology and its short-term approach to budget management and investing for long-term health. NICE guidance has not been able to systematically support the uptake of medical devices, so we would like to see all forms of NICE guidance being given mandatory or ring-fenced funding, something that would help address the uptake issue, especially for medical devices.

A systematic process for the adoption and diffusion of technology is also needed. Focusing on a small number of technologies, perhaps as few as ten a year as at present, is unlikely to have a transformative effect on NHS healthcare delivery and make it fit for future purpose.

While the MTG is pleased overall, and in principle, with the report’s conclusions and recommendations, we now need to see practical involvement from NHS leaders as they act on them without delay.

For the NHS to be truly innovative, it must stop talking and make the changes it knows it must.

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