How the system can make the most of the unique role of specialist hospitals.
Innovation and Technology Tariff
Innovations available at zero cost
An Innovation and Technology Tariff launched in April 2017 means that NHS providers and commissioners can be reimbursed via NHS England for implementing specified cost-saving, outcomes-based innovations.
The Innovation and Technology tariff will help cut the hassle experienced by clinicians and innovators in getting uptake and spread across the NHS. It guarantees these innovations can be acquired at zero cost.
The innovation categories are:
- Guided mediolateral episiotomy scissors to minimise the risk of obstetric injury – Approximately 15 per cent of births in England require the woman to have an episiotomy. Of these, around 25 per cent experiences a complication called Obstetric Anal Sphincter Injury, which causes anal incontinence and which may require reconstructive surgery. Using acute 60 degree angle episiotomy scissors during childbirth reduces the risk of this life changing complication. Preventing these injuries dramatically increases the quality of lives of new mothers who have undergone this procedure and halving litigation costs alone could save the NHS in the region £23.5million. Download implementation toolkit
- Atrerial connecting systems to reduce bacterial contamination and the accidental administration of medication – Although rare, accidental injection of intravenous medication into an atrial line can lead to catastrophic injuries which sometimes require major amputations. Innovations that ensure this does not happen will increase patient safety in NHS hospitals. Download implementation toolkit
- Pneumonia prevention systems which are designed to stop ventilator-associated pneumonia – 100,000 patients are admitted for ventilation in the UK critical care units each year and 10-20 per cent will go on to develop ventilated associated pneumonia (VAP). Between 3,000 and 6,000 people die from this type of pneumonia every year and prevention would save many lives. Treating VAP costs the NHS between £10,000 and £20,000 per patient and conservative estimates for prevention are savings to the NHS of over £100 million. Download implementation toolkit
- Web based applications for the self-management of chronic obstructive pulmonary disease – Digital applications for the self-management of chronic obstructive disease of the airways (COPD) improve the quality of life for patients living with COPD. They give patients the ability to manage their condition by more effective use of their inhalers, and support for pulmonary rehabilitation without the need for face to face sessions. The savings based on reduction in the need for face to face pulmonary rehabilitation sessions are on average over £140,000 per year per CCG. Download implementation toolkit
- Frozen microbiota transplantation for recurrent Clostridium difficile infection rates – Faecal microbiota transplantation is a treatment for clostridium difficile infection. It is an effective alternative to antibiotic treatment for CDI at a comparable cost. High cure rates (90 per cent) and reduced use of antibiotics equal a win-win for patients and the NHS.
- Prostatic urethral lift systems to treat lower urinary tract symptoms of benign prostatic hyperplasia as a day case – An alternative surgical procedure for Benign prostatic hyperplasia (BPH), a common and chronic condition where the enlarged prostate can make it difficult for a man to pass urine, leading to urinary tract infections, urinary retention, and in some cases renal failure. This is an alternative to existing surgical treatments – TURP (transurethral resection of the prostate) or laser. These existing treatments involve cutting away or removing existing tissue, require an average hospital stay of three days and often catheterisation for many days post-surgery. This procedure uses adjustable, permanent implants to pull excess prostatic tissue away so that it does not narrow or block the urethra. Following the procedure, patients return home after a few hours, typically without catheter, and follow-up is normally by telephone. Patients have significantly fewer side effects (notably zero risk of permanent sexual dysfunction) and post-operative complications, such as infection and bleeding, compared with existing alternatives. The procedure is increasingly carried out under a local anaesthetic.
Separately from the tariff, there is central funding for CCGs to purchase mobile ECG devices, which patients can use to identify and measure atrial fibrillation through mobile ECG technology. Early detection of atrial fibrillation in patients helps to prevent stroke, a serious and life threatening medical condition which can lead to long periods of rehabilitation and decreased independence and enjoyment of life for the patient and huge costs to the NHS. Download implementation toolkit