National Institiue for Health and Clinical Excellence

Annual Review - 2012/2013

Promoting the adoption of innovative medical technologies

Given the growing constraints on resources faced by the NHS, there is an increasing need for innovative technologies that are both clinically effective and increase the efficiency of services.

NICE's medical technologies guidance encourages innovation, by helping the NHS adopt clinically effective and cost-efficient new devices more rapidly and consistently.

We evaluates a range of medical devices or tests which deliver treatment. These include those implanted during surgical procedures, technologies that give greater independence to patients, and diagnostic devices or tests used to detect or monitor medical conditions.

Technologies that NICE should produce guidance on are selected by the Medical Technologies Advisory Committee (MTAC). This committee consists of a range of clinicians, scientists, academics and lay people.

Products showing most promise are then routed to the most suitable guidance programme. The MTAC also develops recommendations on technologies that NICE issues as Medical Technologies guidance.

In January 2013, NICE issued guidance on a device used to heal fractured bones. EXOGEN is an ultrasound bone healing system, used for treating long bone fractures that have failed to heal after 9 months.

The device aims to promote bone healing by using ultrasound waves to stimulate the production of growth factors and proteins, which increase the removal of old bone, and increase the production of new bone.

A small transducer is used to deliver the ultrasound waves straight to the site of the fracture. For patients wearing a cast, a hole is cut, allowing the transducer to make direct contact with the skin at the fracture site. The ultrasound waves are delivered in 20-minute sessions which the patient can administer themselves daily at home.

Professor Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said: "We are pleased to publish final medical technology guidance which supports the use of EXOGEN for treating long bone fractures which have not healed after 9 months.

“NICE's independent Medical Technologies Advisory Committee (MTAC) considered that there was evidence to show that using the device in this situation resulted in high rates offracture healing."

She added: “Using EXOGEN for treating long bone fractures which have not healed after 9 months is estimated to potentially save the NHS £1164 per patient compared with standard management, as surgery would be avoided. The device is also more convenient for patients as it's intended to be used in the patient's home.”

Helping to pick up cases of atrial fibrillation

In January 2013, NICE recommended a new device that allows GPs and practice nurses to detect pulse irregularities and pick up cases of atrial fibrillation whilst routinely measuring blood pressure.

In its guidance on WatchBP Home A, NICE says the device reliably detects AF and may increase the rate of detection when used in primary care, allowing preventative treatment to be given and to reduce the incidence of AF-related stroke.

NICE also says the WatchBP Home A device should be considered for use in people with hypertension or those being screened for hypertension in primary care. People with suspected AF should have an electrocardiogram (ECG) in line with current AF guidance from NICE.

NICE estimates that around 74,000 people with AF will be detected nationally, who can then receive treatment if the device is used.

Cost savings are expected to reach £26.7 million per year, once a steady state of use is reached. Savings will mainly be achieved through avoiding stroke and through a reduction in the number of ECGs needed to check false-positive results, which occur when the pulse is taken by hand.

Details of how WatchBP Home A was adopted by one particular GP can be found in a case study that was submitted to the NICE Shared Learning database.

The example includes some of the benefits seen from using the device, as well a summary of results from the first six months of its use.

Medtech guidance encourages innovation, by helping the NHS adopt clinically effective and cost-efficient new devices more rapidly and consistently