Innovation and Technology Payment/MedTech Funding Mandate

MedTech Funding Mandate Checklist The role of the DDICB Clinical Policy Advisory Group (CPAG) is to act as a point of entry for the local Integrated Care System. The MedTech Funding Mandate DDICB Checklist for Service/Innovation Manager has been designed to support the system by ensuring that investments align with system goals and result in tangible benefits for patients and healthcare providers.

MedTech Funding Mandate 2023/2024 Technology Signaling (MTFM)

What is MedTech Funding Mandate:

• The MedTech Funding Mandate is a NHS Long Term Plan commitment to get selected NICE-approved cost-saving devices, diagnostics and digital products to NHS patients more quickly
• Policy document ensuring ICB funding for selected products, so healthcare providers can make available to NHS patients
• Implementation within the NHS - supported by Academic Health Science Networks (AHSNs)

2023/2024 

It has been decided that no additional technologies will be added to the MedTech funding mandate for 2023/24. Instead, systems are asked to prioritise the appropriate adoption of 2021/22 and 2022/23 technologies where this has not yet occurred. 

2022/2023

The technologies that will be supported by the policy in 2022/2023 are categorised into two themes:

1. Treatment for Benign Prostatic Hyperplasia (BPH) a common condition in ageing men and others with a prostate (trans women, some non-binary and some intersex people). It is currently treated with the surgical procedure, transurethral resection of the prostate (TURP) which usually requires the patient to stay in hospital for 1 to 3 days. Four less invasive innovations allow patients with BPH to be treated as day cases. Providers will not be expected to implement all four technologies, instead, each would be expected to work with its AHSN and the Getting It Right First Time (GIRFT) Urology Area Networks to understand its tech.
2. Improving the patient experience during procedures technologies are innovative alternatives to otherwise more invasive and costly procedures.
   Thopaz and Spectra Optia use digital technology to increase efficiency and improve outcomes compared to current procedures and Xpress is a minimally invasive alternative to invasive sinus surgery, thus reducing the risk of complications and improving patient recovery, outcomes and experience.
   
   

Theme	Technology	Description	NICE Guidance
Benign Prostatic Hyperplasia	UroLift	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.	MTG58
	GreenLight XPS	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.	MTG29
	Rezum	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.	MTG49
	PLASMA system	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.	MTG53
Improving the patient experience during procedures	XprESS multi-sinus dilation system	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 the adjacent bone and paranasal sinus structures. This has the potential to reduce the tissue lost compared to traditional functional endoscopic sinus surgery (FESS) procedures.	MTG30
	Thopaz+ portable digital system	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.	MTG37
	Spectra Optia	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.	MTG28

2021/2022

The MedTech Funding Mandate Policy was launched on the 1st April 2021 and in its first year 2021/2022 supported four NICE-approved, cost saving technologies which will continue to be supported in 2022/2023.

The technologies that were supported are:

1. Placental growth factor based testing - a blood test to rule out pre-eclampsia in pregnant women
2. SecurAcath - for securing percutaneous catheters
3. HeartFlow - creates a 3D model of a patient's coronary arteries and assesses the extent and location of blockages
4. gammaCore - a handheld device which alleviates the symptoms of severe cluster headaches

These technologies are commissioned as per the requirements of the mandate. For further details please see Annex 1of the MedTech Funding Mandate Policy.

 
The proposed National Tariff Payment System clarifies the funding arrangements as follows:

• Aligned payment and incentive arrangements, items on the tariff's innovative products list would be funded by the commissioner on a cost and volume basis through the High Cost Tariff-Excluded Devices (HCTED) program. Any additional cost of implementation should be factored into the fixed element. 

Implementation

The MedTech Funding Mandate (MTFM) program is supported by the NHS England and NHS Improvement Innovation, Research and Life Sciences team, and implementation of the technologies is via the EMAHSN network.

(The above link includes contact details for the local Network).

Innovation and Technology Payment

Additional information has been provided in the Guidance on finance and contracting arrangements for H1 2021/2022 (March 2021)

All other technologies not covered by the MedTech Funding Mandate are not commissioned and require the submission and subsequent approval of a business case as per the Interventional Procedures Guidance Policy.

For more information on ITP please click on the following links:

NHS England Innovation and Technology Payment (ITP) 2020/2021

Innovation and Technology Payment - Technical Notes