• £25m commissioning project under fire from Association of British Healthcare Industries
  • ABHI says delays are damaging UK’s reputation for innovation
  • NHS England urged to review new evidence over effectiveness of treatments

An organisation representing health technology firms has claimed a “dysfunctional” NHS England project is denying patients access to “life changing” treatment.

The Association of British Healthcare Industries said the Commissioning Through Evaluation project also “damages the reputation of the UK” as a destination for innovative companies. The £25m programme has been hit by delays since it was launched in 2013, it added.

HSJ revealed last month that two of the six CTE projects were facing delays after trusts failed to submit data to allow evaluation of trials.

The ABHI, representing firms producing 80 per cent of medical technology used in the NHS, said European countries and the US were already offering innovative treatments to patients.

A spokesman for ABHI said: “While NHS England continues with a process that appears, from the outside, to be dysfunctional, our nearest neighbours are all making these technologies routinely available.

“Further delay means more patients miss the opportunity for life changing interventions and damages the reputation of the UK as a destination for innovative companies and technologies.”

NHS England said the next stage of the CTE process would consider new evidence.

An NHS England spokesman said: “We are fully supportive of adopting innovations that will bring benefits to patients and if there is more high quality evidence this will be considered within the next stage of policy development.

“We continue to work with clinical staff, patient groups and other stakeholders, including ABHI, and have confirmed processes and timelines with them.”

The programme enables limited numbers of patients to receive treatment that shows “significant promise” but is not currently funded by the NHS.

The six projects under consideration are:

  • Left atrial appendage occlusion, which could reduce strokes in people with atrial fibrillation. Ten centres have given the treatment to 450 patients.
  • Patent foramen ovale closure, aimed at preventing recurrent strokes and improving survival rates, with trials under way in 18 specialist centres.
  • Percutaneous mitral valve leaflet repair for mitral regurgitation (MitraClip) used to treat patients with heart failure and prevent the need for open heart surgery. Three centres are involved in the scheme.
  • Selective dorsal rhizotomy, a procedure aiming to increase mobility in children with cerebral palsy. By March 2016, 140 children had undergone the treatment at five SDR centres.
  • Selective internal radiation therapy, a form of radiotherapy using radioactive beads to treat cancerous tumours in the liver that cannot be removed by surgery. Around 220 patients a year were expected to be treated with SIRT at 10 centres.
  • Stereotactic ablative radiotherapy, which allows a more precise delivery of radiotherapy with high doses applied to specific areas with less damage to surrounding healthy tissue. Up to 750 patients were expected to be given access to treatment at 17 centres when the trial was launched in 2015.

Delays mean decisions on innovative treatments are facing indefinite postponement and there has been a “lack of transparency” over processes and timelines, the ABHI said.

It said the examples highlighted by HSJ demonstrated a “lack of a robust, rapid process to gather and analyse evidence and make decisions”.

There was a “mismatch” between NHS England and the government’s ambition to speed up access to innovative devices for NHS patients, it added.

In response to HSJ’s original story, NHS England said it would bring forward the review decision “if more high quality evidence becomes available before the independent evaluation is complete”.

However, the ABHI claimed a “plethora” of new evidence had been published.

“We recognise that at the start of the CTE programme in 2013, there may not have been sufficient evidence to make a commissioning decision,” the ABHI spokesman said.

“However, we are now four years down the line. There is significantly more evidence and international precedents for funding for defined group of patients but there are still no transparent timelines on when an NHS England decision will be made.”

It is calling on the national commissioning body to implement a rapid review process of the available evidence to make in year changes.

The spokesman added: “CTE has been described as an innovative and effective way of giving patients access to medical technologies proven to work elsewhere, and could help some of the most vulnerable groups in our society – children, the elderly, people living with heart failure and cancer.

“With the evidence now published, they should quickly be made available to patients in England.”