A healthier prognosis?

As an ageing, wealthier and more demanding population grows to expect more from the NHS, politicians are belatedly waking up to the huge role technology will play in delivering on their promises. For the first time the government and the medical technology industry are attempting to hammer out a common approach that will benefit the health and the wealth of the nation.

Over the next few months the recommendations of the Healthcare Industries Taskforce (HITF), a joint initiative between ministers and technology providers, are due to begin filtering through to tangible policy. Ministers are talking up the twin benefits of bringing new technologies into the NHS and stimulating growth in a sector that could deliver hi-tech jobs and export revenues for the UK. The industry itself is unsurprisingly delighted by the government’s attention, but is also keen to stress the urgency of acting on the recommendations.

John Wilkinson, director general of the Association of British Healthcare Industries, said a strong relationship between technology providers and the NHS was a vital component of a successful UK sector. This relationship has been erratic at best so far. According to Wilkinson, the NHS has often been a slow adopter of medical technologies. As the biggest single provider of healthcare in the world, this was hardly helpful to UK businesses operating in the sector. ‘It’s difficult to have a good industry base when you haven’t got a dynamic customer,’ he said.

That the NHS is a slow and difficult environment in which to introduce new technologies is hardly a surprise. As successive governments have discovered, imposing rapid and decisive change on the monolithic organisation makes turning around the proverbial oil tanker look straightforward. But if the HITF programme produces results, the NHS’s very size and purchasing power could turn a weakness into a significant asset, potentially changing the UK into a hotbed of advanced medical technology with a vibrant development base and an awesomely influential prime customer.

So what changes are planned? All sides agree that a quick and effective process for evaluating the performance and cost-effectiveness of new medical technologies is vital to the NHS and the industry alike. To this end, a new Device Evaluation Service (DES) will be developed that HITF hopes will deliver improvements over the current system. An important element of the plan involves moving the existing DES from its home inside the industry’s regulatory body and making it part of the NHS’s procurement operation, bringing it closer to those who decide whether to buy in to a new technology.

It is clear that the NHS’s purchasing and supply practices present a bewildering obstacle to external companies seeking a foothold for their innovations inside the health service. HITF hopes to establish a framework for procurement at regional level, giving technology developers a single point of potential access to more hospitals.

HITF also recommends measures to stimulate a culture of innovation, including the establishment of a new innovation centre and a fund to promote the development and exploitation of new products and procedures. Allied with familiar commitments to strengthen ties with academia, create centres of excellence and focus more on R&D, the HITF programme has nothing anyone could object to in principle. Those in the medical technology sector are counting on it delivering practical results.

The ABHI’s Wilkinson, whose members include some of the big guns of the sector such as Johnson & Johnson, Smith & Nephew, Smiths Medical and Tyco Healthcare, claimed the very fact that the government had engaged with the industry proved it was moving on to the radar of policy makers. The prospect of closer co-operation between the NHS and the medical technology business should help it to emerge from under the shadow of the pharmaceutical sector and establish its credentials as a £4.5bn industry in its own right, earning £3bn in export revenues. ‘The HITF report is very significant,’ said Wilkinson. ‘It is the first material engagement between the government and this industry as a whole.’

Despite his enthusiasm for the HITF programme, however, Wilkinson knows that no reform of medical technology uptake in the NHS can succeed without the support of doctors and nurses, who will be its end users. ‘We believe clinicians have been disengaged from the process and want to pull them back in,’ he said, adding that ‘tussles’ over procurement between clinical specialists and managers were frequently unhelpful.

Wilkinson also expressed fears that senior doctors would be too stretched ‘doing the day job’ to be able to contribute to the R&D process needed for the successful introduction of new medical technologies.

Despite these concerns, Wilkinson said senior doctors are increasingly aware of the huge opportunities presented by advances in medical technology, and the implications for their career prospects. ‘Technology is producing huge shifts away from certain skills and towards new skills,’ he said. ‘Surgeons, for example, are using technology that requires a completely different skill set from what went before. The medical community is realising that if they don’t use the leading-edge technology, their reputation is in danger of slipping.’

For HITF to bring decisive impetus to the UK’s medical technology sector, however, it will have to reach beyond the big multinationals and make an impact on the growing number of SMEs operating in the area. According to estimates quoted in the HITF report, 85 per cent of healthcare companies in the UK have an annual turnover of less than £5m.

If the major players, with their multimillion-pound marketing budgets, have problems introducing new technologies to the NHS, the situation is harder still for businesses that may comprise no more than a few dozen highly skilled technical staff.

Diana Hodgins, managing director of European Technology for Business (ETB), a developer of advanced engineering systems for the medical sector, said of the HITF agenda: ‘The intention is right and the words sound good, and we should be positive. However, the questions I always ask about these things are: how and when?’

Hodgins said that HITF at least represents a statement of intent that medical technology SMEs can use to fight their case when presenting innovations to healthcare buyers.

Smaller companies are also aware of the benefits of banding together to give themselves extra weight in the sector. Hodgins is a leading figure in Medilink East, a body set up to represent medical technology SMEs in the east of England that now numbers about 130 members. ‘We’re growing and we’re starting to get a bit of clout,’ said Hodgins. ‘With that type of scale you begin to command far more attention than a little company on its own.’

Either via HITF or the efforts of SME innovators to push their case, the UK’s medical technology sector is determined to raise its profile. Whether the vagaries of the NHS will allow it to reach its potential remain to be seen, but all agree that this is crunch time. ‘We have a two-year window,’ claimed Wilkinson. ‘We’ve got a vibrant sector with the potential to deliver high value-added jobs, but the government hasn’t always been aware it’s there. As a country we have to have an industrial base, and we are arguing that this sector is a highly promising one.’