• The Government should create a healthy ecosystem for medical technology innovation and uptake. 

The benefits of reforming the MedTech pathway and reimbursement mechanisms are very clear – a simpler, more accessible process for the MedTech sector; greater access to the latest technology for patients; and an NHS fit for the 21st Century. However, despite a range of strategies and policy initiatives over the past 20 years to support the medical technology sector,  challenges to the adoption and spread of innovation remain. 

To create a health ecosystem for MedTech adoption and spread, the Government must seize the opportunity of reform through the implementation of the MedTech Strategy, the recommendations of the ongoing Sinker Review, as well as recommendations from MTG reports, such as Deja Review. Without reform, and the necessary support for implementation, it is likely that the problems for the sector will remain.

• The Government should set up a cross-system project board to review and drive change in NHS culture, both locally and nationally. 

There are entrenched challenges for ICSs and their constituent parts, leading to poorer outcomes for patients, including siloed working, failures to share best-practice and unequal access to best quality care, including through proved medical technologies. 

Good practice, whether in innovation or clinical practice, is abundant across the NHS in England. However, it is often isolated, and although sometimes shared within ICS structure, are not shared widely across external Trusts or ICSs, exacerbating entrenched variation in outcomes for patients.

By sharing best practice, learning from others and adopting improved clinical pathways that utilise the most innovative medical technologies, the NHS has the ability to support better care of patients, improve equality of access, and reduce the elective backlog of care. The Department for Health and Social Care should take a leading role in developing, delivering and monitoring forums to allow commissioners and providers to learn from each other and raise standards across the whole country.

• The Government and DHSC should improve ICS accountability structures, aimed at ensuring patients have access to appropriate medical technology and that ICSs follow national guidance. 

There are organisational barriers impacting the effective implementation of innovative technology. Often the cost of a technology is prioritised over its wider value to clinical outcomes, long-term cost efficiencies and patient choice. An unwillingness to invest in the latest technology and think holistically of overall value can lead to a failure to utilise the latest innovations to improve efficiencies and outcomes. 

It is vital that patients are able to access the right care, at the right place and the right time, and without consistent commissioning of medical technologies, this will not become a reality. The Government should provide the resources and mechanisms to ensure innovation is managed and measured at ICB level by ensuring there is an accountable officer for innovation within each ICS. This will allow for an effective mechanism to foster and deploy research and innovation, reforming the organisational culture of the NHS. 

• The Government should reduce regional variation in access to proven medical technologies for patients by assessing local barriers to access and implementing action to overcome them

The MTG’s Ration Watch 2024 report found that there is considerable variation in the geographical performance of ICBs, meaning that where you live is a significant factor in the quality and speed of your care. Direct intervention from the DHSC and Government is essential to addressing persistent issues in variation.

Identifying areas of best practice within the ICS system is essential to overcoming regional variation, as well as supporting ICBs to raise their standards to adopt examples of best practice. National bodies should work to standardise the pathway for medical technologies and innovations to access the NHS. Without further consideration from national bodies, the postcode lottery will persist, and the NHS and patients will continue to face challenges to access to medical technologies. 

• The Government should mandate patient involvement at all levels of decision making across ICBs and the Department of Health and Social Care. 

The value of including patients at all decision-making within the NHS cannot be understated. Having structures in place that effectively represent and involve patients within decision-making processes are not only empowering for the individual, but also provide significant benefits to NHS organisations. The MTG believes that those who receive care and interact with the NHS hold invaluable insights into the delivery of healthcare and how this could be improved. Integrating meaningful patient involvement in structures of decision-making has the potential to improve patient outcomes, ensure personalised care is prioritised, and provide deeper understanding of patient experience which can improve NHS services.  

As ICSs continue to develop, the MTG believes the NHS has the opportunity to ingrain meaningful patient involvement in the structures of local, as well as national decision making.