Accelerated Access Review published – well worth a read

The Accelerated Access Review is published today. Readers with long memories will recall that it kicked off in the Spring of 2015 aimed at accelerating the uptake of innovation in to the NHS. It had three technical streams – pharma, medtech & digital health, plus a patient stream. This editor, as Managing Director of DHACA, was the digital health champion.

DHACA members were heavily engaged in the consultation, so it is gratifying to see that all DHACA recommendations were accepted. Most important were recommendations that:

• NICE broaden its reach to include more medtech & digital health recommendations, and consider other means of funding;
• there be closer alignment of regulatory and NICE data requirements and processes (currently, there can be duplication);
• a strategic commercial unit is established in the NHS;
• a small amount of funding is offered to support the commercialisation of disruptive innovative technologies that significantly change care pathways;
• products not referred to NICE should be assessed only once by NHSE;
• the route for digital products should build on the “Paperless 2020” simplified app assessment process;
• the Crown Commercial Service, in partnership with NHS Digital, NHS England, the Department of Health and other system and technology partners, should consider how best to develop an accessible, simple and swift competitive process for procuring digital products from SMEs;
• NHS England, working with NHS Digital, should develop a generic framework for app prescription.

When implemented, these and all the other recommendations in the report will go a long way to overcoming the challenges faced by SMEs currently operating in this space, making access to the NHS easier, reducing duplication and enabling speedy remuneration for effective products & services. This editor has often commented in these columns that the NHS will begin seriously to save money on medicine usage when doctors can compare apps and medicines on the same basis, and prescribe them on the same basis: if these recommendations are carried out, that will be achieved.

Importantly, throughout the report, there is the recognition of the key feature of digital health that differentiates it from medicine: digital primarily generates benefit from enabling new care pathways, whereas medicine delivers benefit often irrespective of care pathway (within reason). This in turn impacts many of the digital health-specific recommendations.

As is unavoidable for an enterprise of this reach, the recommendations are fairly generic. As Sir Hugh says in his introduction, this is only the beginning – the hard work begins now with turning these recommendations in to specific actions with budgets, owners, milestones & deliverables: DHACA is very much up for that!

A finally thought is that, if you read nothing else in the report, do read Annex C on page 67, which is a summary of the proposals for digital.

Disclosure: it goes almost without saying that this editor’s contribution to the Accelerated Access Review was very significant, and is kindly recognised at both the start & the end of the report.