National Institiue for Health and Clinical Excellence

Annual Review - 2009/2010

NICE's Diagnostics Assessment Programme started work on four topics this year and its first guidance is expected to be published in October 2011

Innovative ways of improving care

The Medical Technologies Evaluation Programme (MTEP) and Diagnostics Assessment Programme (DAP) are the newest additions to our work at NICE.

The MTEP programme selects new or innovative medical technologies and assesses their case for take-up, in terms of effectiveness and value, in the NHS. This allows for the adoption of technologies – which are shown to offer particular benefits for patients or the NHS – to be promoted more quickly and consistently.

The technologies evaluated include those which are implanted during surgery, that help clinicians to diagnose or exclude disease, and equipment that aims to give more independence to patients.

We announced the members of the medical technologies advisory committee (MTAC) in April 2010, and published our process and methods guides for consultation in June 2010.

MTEP has published three pieces of medical technologies guidance so far – all of which recommended the use of the technologies being evaluated. The first to be approved was the use of a balloon catheter (SeQuent Please) on coronary artery surgery. Our guidance advises the NHS that SeQuent Please can help both patients and the NHS in the long-term by reducing the number of cases that need further treatment for restonosis.

Novel ways of identifying disease
Helping to detect and identify disease forms an important feature of NICE’s work in medical technologies. The Diagnostics Assessment Programme (DAP) produces guidance to support the consistent and timely adoption of diagnostic technologies. These technologies offer the potential to improve patient outcomes and provide wider benefits, such as leading to cost savings. The DAP is closely linked to the medical technologies programme, as topics it considers are selected by MTAC.

This year saw the formation of the Diagnostics Advisory Committee that will evaluate diagnostics technologies and make recommendations on their use. The committee consists of standing members from diverse backgrounds including NHS trusts, academia and industry, together with specialist members recruited for each topic.

The DAP started work on four topics this year and the first guidance it produces is expected to be published in October 2011. A pilot project for the programme that began in 2009 was also completed this year.

Mark Campbell and Nick Crabb, Associate Directors of NICE's Medical Technologies Evaluation Programme and Diagnostics Assessment Programme respectively, talk about a busy year for their teams.

What have been the highlights in the work of the programmes this year?

Mark: “The first piece of published guidance on SeQuent Please was always going to be a highlight for MTEP.”
Nick: “The completion of the pilot topic on non-invasive tests for liver fibrosis was no less a milestone for the diagnostics team. There was a real sense of achievement in seeing two completely new independent advisory committees getting down to business and, very quickly, adapting to the distinct challenges of selecting and evaluating medical technologies.”

What challenges have the programmes faced, and how have the teams overcome these? 

Mark: “In addition to developing and working with completely new evaluation methodologies, the journey to understand and engage with our stakeholders – clinicians, patient groups, the devices and diagnostics industry and Health Technology Assessment academics – has been a significant, but enjoyable, challenge.”
Nick: “The UK medical technology industry is strong and successful, but incredibly inventive and diverse. So, talking to and working with individual manufacturers has provided huge learning opportunities for the teams.”

How has the work of the pilot project informed the work of the programmes?

Mark: “MTEP started with live topics based on notifications from manufacturers. Every topic provided valuable experience in the revision of the process and methods guides which were subject to public consultation in the summer of 2010.”
Nick: “For the diagnostics programme, the pilot topic showed the complexities of assessing diagnostics technologies, and was important in the development of the methods and processes for the ongoing programme.”