Future innovation crucial as patients rely heavily on new medical devices
A national body set up by the Welsh Government is aiming to improve access to the latest health technologies. Here Dewi Powell, from Health Technology Wales (HTW), explains how the best ideas are supported by the organisation from innovation to implementa
When we need treatment for an injury or illness, we often take our treatments and the technology involved for granted.
But there is an organisation in Wales responsible for identifying these latest advancements and getting them to the people who need them.
Health Technology Wales (HTW), a national body set up by Welsh Government, is tasked with appraising and adopting non-medicine health technologies.
Their remit includes medical devices, procedures, rehabilitation and therapies for patients, frontline care givers, clinical commissioners or industry.
Ideas and interventions presented to the organisation can vary from relatively simple items like wound dressings, through to complex robotic surgical equipment.
Dr Susan Myles, director of Health Technology Wales, said: “There are more than 500,000 medical devices on the market and an annual UK spend of £11bn for medical devices alone.
“Ensuring clinical and cost effectiveness is vital to maximise resources in Wales and provide the most benefit for service users and care providers.”
Health Technology Wales’ has processes in place for appraising new ideas, also known as a health technology assessment (HTA).
A team of research professionals undertake a rapid review of the available evidence for each technology.
Then decision-making groups consisting of representatives from across the country consider the review and apply their expertise to provide independent, evidence-informed Health Technology Wales guidance.
Since HTW was set up in November 2017, nine pieces of guidance have been produced.
These inform health and care commissioners in their decisions to adopt innovative technologies to make a difference to people’s lives in Wales.
Previously assessed technologies include mechanical chest compression for patients with cardiac arrests, radiotracers for recurring prostate cancer and glucose monitoring devices for people with diabetes.
The first mechanical devices.
The topic was proposed by the Welsh Ambulance Service NHS Trust who wanted to know whether these devices would be an effective option for people who have a cardiac arrest.
Survival rates are low for people who have a cardiac arrest out of hospital and need to be resuscitated.
Paramedics try to keep the heart pumping while the patient is being transferred to hospital, usually by repeatedly pressing down on their chest. Mechanical chest compression devices are designed to perform this same action.
However, Health Technology Wales’ evidence appraisal concluded that the devices didn’t improve survival rates and were expensive.
Therefore, their guidance didn’t support routine use of the mechanical chest compression devices.
On Health Technology Wales’ first anniversary, Health Secretary Vaughan Gething AM said: “They are delivering high quality, evidenceinformed advice to our health boards on a range of non-medicine technologies.
“This is important work that will ensure our health service in Wales is at the forefront of modern technology.”
Health Technology Wales’ work is recognised by HTA organisations in other countries too.
Strong links have been forged on UK, European and world levels to share resource and knowledge.
This has enabled Wales to not just appraisal focused on chest compression stay updated on the latest findings but also influence the global HTA community.
Going one step further, Health Technology Wales is increasing knowledge and inspiring innovation through its series of HTA and Health Economics workshops.
These free workshops are open to everyone and running throughout 2019.
The workshops use real-life examples to introduce participants to key concepts and methods.
Participants are equipped with transferable skills to use in the workplace and are encouraged to consider technology topics they can submit to Health Technology Wales.
Elise Johanson, a third year medical student from Cardiff University, said: “I can use the skills I learned in this workshop to critically appraise the research, and to decide for myself if I think the evidence is strong enough to support a clinical decision in practice as well as decisions about future health technologies.”
In March and April 2019 an “open topic call” was held by HTW to actively seek innovative technology suggestions.
A “suggest a topic” form on their website was filled in 50 times and these submissions are being fed into the 2019-20 work programme.
Most of these topics came from organisations within NHS Wales, and there were also submissions from industry and government.
A patient and public involvement (PPI) group has been created and there are plans to set up a similar group for industry.
Along with future plans for a scientific advice function, Health Technology Wales is ensuring it is engaging stakeholders and well positioned to facilitate future innovation. 1. FreeStyle Libre flash glucose monitoring
Flash glucose monitoring involves a small sensor being placed under the skin which patients with type 1 and type 2 diabetes can scan at any time to read their blood sugar levels.
It is said to greatly reduce the need for finger prick tests which involve diabetes patients drawing blood up to 10 times a day.
2. Sacral nerve stimulation (SNS) Sacral nerve stimulation (SNS) is a treatment for faecal incontinence that involves direct, chronic, low-voltage electrical stimulation of the sacral nerve roots.
This therapy addresses the communication problem between the bladder/bowel and the brain that may be causing symptoms.
It can help to restore normal bladder or bowel function and has been used to treat 200,000 worldwide.
3. Gallium prostate-specific PET radiotracers
Many men who have been treated for prostate cancer may develop a recurrence of the cancer at a variable time after their initial treatment.
These special radiotracers provide a higher degree of diagnostic accuracy on which to base management decisions as compared with conventional tracers.
■ Visit www.healthtechnology. wales for more information.