Accelerating AccessJanuary 23, 2017
We act as honest brokers within our region, mobilising expertise and knowledge across the NHS, academia and industry to help improve lives, save money and drive economic growth through innovation. Our regional partnerships are helping to deliver system transformation locally, described by the Five Year Forward View. As 15 AHSNs we work together in ways unprecedented across health and care, delivering improvement at pace and scale. This is having real impact through our collective work including the successful NHS Innovation Accelerator – now reaching 388 organisations within the NHS – Patient Safety Collaboratives and the Innovation Pathway; improving health and driving economic growth.
The latest work to recognise the unique role that AHSNs can play is the Accelerated Access Review, (AAR). This was an independently chaired review of innovative medicines and medical technologies, led by Sir Hugh Taylor and supported by the Wellcome Trust and the Office of Life Sciences, which published its final report in late October 2016.
It contains a series of recommendations to the NHS, which will need to be properly considered by NHS England and others, but encouragingly, the report contains a letter from Simon Stevens, where he commits: “We’ll support the AAR’s streamlined pathway to identify high value innovations. We’ll then help pull them through into mainstream care – building on our AHSNs, innovation testbeds, and our new Innovation and Technology Tariff. And where it makes sense, we’ll be increasingly open to agreeing innovative win/win product-specific reimbursement models …” (Taylor, 2016, p.10).
The report outlines how the UK can make far more of its Life Sciences and research expertise, speed up clinical trials and subsequent endorsement and adoption of new drugs, medical devices and digital technologies. The AAR’s approach is shown in Figure 1, below.
It also considers the lessons learnt from when we have got this right, the triumph of the speed of development and dissemination relating to Ebola is rightly highlighted as a fine example of this, with the MHRA’s Clinical Trials Unit fast tracking Ebola studies, Expert Advisory Groups and trial sponsors.
Figure 1: A summary of the Accelerated Access Review’s proposed approach (Taylor, 2016, p.14, reproduced with permission)
The report is well worth a read and is available here. From the 70 pages I’ve précised the top 10 areas for AHSNs and summarised these.
Accelerated Access Top 10 Changes for AHSNs
Key changes for us from the review include:
|1||Strengthening of remit: The report calls for “A new mandate for AHSNs should support the local spread of adoption and enable as standard framework for local evaluation” (Taylor, 2016, p.50). It is described as a “new, strengthened remit for AHSNs” (Taylor, 2016, p.50) and that AHSNs – among others – will “drive and support the evaluation and diffusion of innovative products” (Taylor, 2016, p.12).|
|2||Clarity of role through a Charter for Innovation Support: “AHSNs, with their existing local networks that include NHS providers and commissioners, academia and industry, should play a vital role in supporting the testing and diffusion of technologies in the NHS. This role should be set put in a new charter with input from NHS England and NHS Improvement which clearly articulates what is expected from AHSNs and enables them to be held to account for local delivery” (Taylor, 2016, p.50).|
|3||Strengthening of our National Network of 15 AHSNs: The offer to innovators will include “access to a strengthened AHSN network which can facilitate local evidence-collection and adoption of innovation” (Taylor, 2016, p.13).|
|4||Better funding: AHSNs should be funded to a level that allows them to fulfil the role outlined in this report (Taylor, 2016, p.51), and there follows a recommendation to provide between £20million and £10million to AHSNs baseline budgets from 2017.|
|5||Providing capacity: the review proposes an additional role for AHSNs in providing capacity and capability locally to NHS organisations who require it, in order to make the most of new innovations. This new role would require funding of around £30million a year, and there is a suggestion that AHSNs that are able to generate match funding through working with charities or industry partners could access these resources (Taylor, 2016, p.52).|
|6||Creation of Innovation Exchanges: AHSNs should galvanise and support local innovation partners to create a network of “innovation exchanges” responsible for diffusing clinical and cost effective technologies across the system” (Taylor, 2016, p.50).|
|7||Supported more strongly: We also recommend that NHS Improvement plays a greater role in leading AHSNs, including supporting them to undertake these activities (Taylor, 2016, p.51).|
|8||Link to Test Beds: AHSNs have been supporting the national Test Bed programme where combinatorial innovation is being explored. The Test Bed we support in the London Test Bed, CareCity, which is bringing together technologies to keep people with dementia as safe as possible. “AHSNs should build on their current involvement in the Test Beds programme by using this learning for their own evaluation role and seeking to collaborate to promote mutual recognition of local evaluations using the national framework” (Taylor, 2016, p.51).|
|9||Testing and dissemination: AHSNs are noted to be “ideally placed to play a role in post-CE mark testing and dissemination of medical technologies, diagnostics and digital products in particular” (Taylor, 2016, p.51).|
|10||Horizon scanning: In Digital Health AHSNs are seen to have a key role in the earliest stages where “AHSNs identify unmet needs” at the ideas generation and identification phase (Taylor, 2016, p.26).|
The following figure shows how the AHSN Network will embed within the system to enable speedier spread and uptake of innovation.
Figure 2: Local and national spread of innovation (Taylor, 2016, p.51, reproduced with permission)
At the Health Innovation Network we, along with colleagues across the other 14 AHSNs, warmly welcome the Accelerated Access Review and are keen to progress its findings at scale and pace, to speed up the best in health and care, across the country.
|Taylor, H. (2016). Accelerated Access Review: Final Report. Department of Health, available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/565072/AAR_final.pdf|