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Achieving better outcomes for the same costs?

As the NHS strives to make efficiency savings of £22 billion, ‘Better Value in the NHS’ a new report from the King’s Fund is calling on doctors, nurses and other staff to engage in a new mission to deliver better outcomes for lower costs. The report argues that rather than focusing on monetary value, the importance of the real task ahead is about maximising the value that is derived from the NHS budget. In the search for better value, efficiency and better outcomes, the case for investment in medical innovation has never been stronger.

The MTG has long argued that the take up of medical technology in the UK is not as good as it should be, given its great potential to provide value for money to the NHS, patients and taxpayers. Recently we explored how far Clinical Commissioning Groups (CCGs) and acute Trusts had progressed in improving patient care through high impact innovations. In the NHS Innovation Health and wealth report (2011), innovation was defined as “an idea, service or product, new to the NHS or applied in a way that is new to the NHS, which significantly improves the quality of health and care wherever it is applied.” However, we have found that even previous innovations that should now be a standard of care, such as insulin pumps, are still not being implanted or commissioned to support the needs of the population. Without fundamental changes to adoption rates of proven innovation, progress will not be made.

Our recent report ‘Innovation Health and Wealth – a scorecard’ shows that there are also significant efficiencies still to be made in both CCGs and Trusts. Some CCGs and Trusts are performing far worse than others and some regions underperforming drastically in some areas of innovation, health and wealth. For example, NHS waiting times for wheelchairs for disabled children have often been 200 days or more. This is a far cry from what was promised in the ‘Child in a chair in a day’ programme. Additionally, reducing emergency admissions and hospital bed days through telehealth was estimated to improve three million lives in five years. However our report shows there’s room for significant improvement, with just 45% of CCGs having agreed new models of technology provision to address this.

In a separate MTG report ‘Adding value: The Economic and Societal Benefits of Medical Technology’ we argued for a reduction in the societal burden of long-term conditions to maximise the cost-effectiveness of health and social care services. According to the report’s findings, better use of innovative technology and methods could help to achieve this. For example, we found that investment in proven medical innovations such as artificial hip/knee replacements, implantable cardioverter-defibrillators (ICDs) and insulin pumps can enable individuals to continue to live fulfilling working and family lives, and prevent their premature withdrawal from the labour market.

Following the recent launch of the ‘Accelerated Access Review’, the MTG hopes that necessary change to promote the use of innovative medical products and devices within the NHS will be implemented at a national level. We also hope that the lessons learned from past initiatives, alongside those in the King’s Fund report, will be heeded to ensure the NHS obtains optimum levels of value and better outcomes from its budget.

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