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About the policy

 

The MedTech Funding Mandate (MTFM) is an NHS Long Term Plan commitment to get selected NICE-approved cost-saving devices, diagnostics and digital products to NHS patients more quickly. The policy launched on 1 April 2021. After the first year of the new policy, new guidance was published for 2022/23. Access the policy guidance here.

The policy supports devices, diagnostics or digital products that are:

  • Effective and improve patient outcomes, demonstrated through positive NICE guidance
  • Cost-saving within three years: NICE modelling demonstrates a net saving within three years of implementing the technology
  • Affordable to the NHS: the budget impact should not exceed £20 million, in any of the first three years

The policy defines a list of NICE-approved technologies that NHS commissioners and providers are mandated to agree local funding arrangements for through their existing allocations. This is to ensure healthcare providers across England enable equitable access to patients.

The policy has three key objectives:

  • Ensure equity in healthcare provision is achieved by monitoring patient access to the supported technologies across the NHS in England
  • Direct the NHS to the medical technology innovations that are most effective and likely to give savings on investment
  • Support the NHS to develop a sustainable approach to overcoming the financial barriers to adopting medical devices, diagnostics and digital products

The MTFM policy is an NHS England initiative, delivered with the support of the 15 AHSNs who work closely with their local ICSs.

The Innovation Agency is supporting trusts in the North West Coast to adopt the products.

 

Technologies included in the 2022/23 policy

 

The technologies included in the MTFM 2022/23 policy are categorised into the following two themes:

  • Benign prostatic hyperplasia (BPH) 
  • Improving the patient experience during procedures; using technology to increase efficiency, improve outcomes and in some cases offer less invasive alternatives.
 

Technologies included in the 2022/23 policy:
Benign prostatic hyperplasia (BPH)

 

Benign prostatic hyperplasia (BPH) is a common condition in ageing men and others with a prostate (trans women, some non-binary and some intersex people). It is commonly treated with the surgical procedure, transurethral resection of the prostate (TURP) which usually requires the patient to stay in hospital for one to three days.

The following four less invasive innovations allow patients with BPH to be treated as day cases and have seen increased utilisation over the last four or five years. However, as recognised by the Getting It Right First Time (GIRFT) urology team, there is still an opportunity to increase uptake of these four innovations, particularly in the context of elective recovery following the coronavirus pandemic.

The four BPH technologies are:

UroLift

 

Lifts and holds the enlarged prostate tissue away from the urethra, relieving compression

The UroLift system lifts and holds the enlarged prostate tissue away from the urethra, relieving the compression of this organ. It can be performed under local anaesthesia in an outpatient setting or ambulatory care centre, and the patient can return home the same day without a catheter. NICE guidance MTG58

GreenLight XPS

 

Uses a laser to reduce the size of an enlarged prostate

The GreenLight XPS vaporises prostatic tissue with a laser. The laser fibre is passed through a cystoscope to photoselectively vaporise the enlarged prostate tissue, leaving a clear urethral channel. GreenLight XPS can be done as a day case procedure, reduces the risk of complications, and allows a quicker return to normal activity. NICE guidance MTG29.

Rezum

 

Uses water vapour to destroy excess prostate tissue

Rezum is a minimally invasive procedure that uses water vapour (steam) to treat BPH. The technology delivers targeted, controlled doses of stored thermal energy in water vapour directly to the region of the prostate gland with the obstructive tissue causing lower urinary tract symptoms (LUTS). Rezum effectively alleviates BPH and patients can be treated as outpatients.

PLASMA system

 

Uses electrodes to cut out prostate tissue

PLASMA is a bipolar electrosurgery system for transurethral resection and haemostasis of the prostate. The system uses electrodes to cut out (resect) prostate tissue and stop any local bleeding afterwards (haemostasis), which avoids the risk of transurethral resection syndrome and reduces the need for blood transfusion. This procedure can be done as a day case.

 

Technologies included in the 2022/23 policy:
Improving the patient experience during procedures; using technology to increase efficiency, improve outcomes and in some cases offer less invasive alternatives.

 

Three technologies are:

 
XprESS Multi Sinus Dilation System

 

A sterile, single-use device for treating chronic sinusitis with a dilating balloon

Specialism: ENT: Chronic sinusitis

The XprESS multi-sinus dilation system is a sterile, single-use device for treating chronic sinusitis. Dilation of the XprESS balloon remodels the bony sinus outflow tract by displacing adjacent bone and paranasal sinus structures. This has the potential to reduce the tissue lost compared to traditional functional endoscopic sinus surgery (FESS) procedures.

Thopaz+

 

A portable, digital chest drain system which accurately monitors and records air leak and fluid drainage

Specialism: Thoracic surgery/ Trauma: Portable digital system for managing chest drains

Thopaz+ is a portable digital chest drain system that provides regulated negative pressure close to the patient’s chest and continuously monitors and records air leak and fluid drainage. The system comprises an inbuilt, regulated suction pump with a digital display, rechargeable battery, tubing that connects to any standard chest drain catheter and a Thopaz+ disposable fluid collection canister. Sensors in the system turn the pump on and off to ensure the pressure level set by the healthcare professional is precisely maintained.

Spectra Optia

 

Apheresis and cell collection platform for people with sickle cell disease who require automated red cell exchange

Specialism: Haematology, transfusion: automated red blood cell exchange in people with sickle cell disease.

The Spectra Optia Apheresis System is an apheresis and cell collection platform for the treatment of sickle cell disease. In a typical exchange procedure, Spectra Optia separates and removes sickle red blood cells from the patient’s blood using continuous flow and centrifugation. These are replaced with healthy red blood cells according to the user-defined software protocol.

Thopaz+ and Spectra Optia use digital technology to increase efficiency and improve outcomes compared to the alternatives, while XprESS is a minimally invasive alternative to sinus surgery.

 

Technologies receiving continued support from the 2021/22 policy are:

 

Placental Growth factor based testing (PIGF)

 

A blood test to rule out pre-eclampsia in pregnant women

Specialism: Women and children’s

PIGF based testing provides fast and accurate diagnosis if PE is suspected, using a simple blood test for placental biomarkers. Blood tests are available from Roche Diagnostics (Roche Elecsys sFlt-1/PIGF Ratio Test) and Quidel Corporation (quidel Triage PIGF test). 

The product is recommended by NICE between 20 weeks and 34 weeks plus six days of gestation. The improved diagnosis allows better ante-natal risk management and provision of appropriate care according to clinical need, with subsequent financial and capacity benefits for the maternity system.

Read more

gammaCore

 

A handheld device which alleviates the symptoms of severe cluster headaches

Specialism: Neurology

Patient-handheld medical device that enables self-administering discrete doses of non-invasive vagus nerve stimulation (nVNS) therapy for the treatment of cluster headache. Reduces need for medication, increases self-management.

The product is recommended by NICE between 20 weeks and 34 weeks plus six days of gestation. The improved diagnosis allows better ante-natal risk management and provision of appropriate care according to clinical need, with subsequent financial and capacity benefits for the maternity system.

Read more

HeartFlow

 

Creates a 3D model of a patient’s coronary arteries and assesses the extent and location of blockages

Specialism: Cardiology

A standard coronary CT scan is uploaded to HeartFlow, which produces an FFRCT, and a 3D model of the coronary arteries. Reduces unnecessary invasive angiograms by specifically identifying site and degree of coronary artery block. For use in stable, recent onset chest pain and suspected angina.

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SecurAcath

 

Uses electrodes to cut out prostate tissue

Specialism: IV access: safety device for PICC lines.

Subcutaneous catheter stabilization device with small nickel feet placed just beneath the skin at the insertion site. Reduces need for adhesive dressings, cleaning time and dislodgement rates.

Read more

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