Innovation and Technology Payment (ITP): One year on

Written by Tara Donnelly, Chief Executive at Health Innovation Network

The latest products available at low or no cost through the NHS Innovation and Technology Payment (ITP) have been announced by NHS England, and we were pleased to see some fantastic innovations that reduce the need for intervention, improve care, reduce infection rates and length of stay, and NHS resources.

Above all, we were struck by the potential for the innovations on this tariff to improve patient safety. Here at the Health Innovation Network, we want to do all we can to help NHS organisations in south London take advantage of them.

Nationally the tariff was a real success in its first year, with myCOPD leading the way. There are now more than 35,000 people actively using this great digital tool to improve their self-management and this number is increasing by 5,000 – 8,000 a month. In total almost 100,000 licences have been sold 60% through the tariff and the rest by CCGs and individual patients keen to self manage. You can read more reflections on the first year of the tariff in my related blog here.

It’s great to see the range of products available this coming year. But as an AHSN, we know that just because a product is free or low-cost that doesn’t mean it’s easy to implement, or that the internal resources are available to support implementation. We want to support Trusts as much as we can.

The support we can offer includes help with internal business cases, advice on information governance, connecting trusts to others who have used the products, advice on how to reclaim funds and use the tariff, and wider advice as needed. If you’re an NHS organisation in south London and would like to access HIN support, please do contact us at kate.covill@nhs.net and ian.knighton@nhs.net or on 0207 188 9805.

The products are:

Available completely free for 2018/19:

• Endocuff Vision – a small device that goes onto the end of a colonoscope and improves the quality of colorectal examination.
• SecurAcath – a device to secure lines that reduces the infection risk for patients with a peripherally inserted central catheter (PICC line). This type of catheter is normally used in people needing intravenous access for several weeks or months in both inpatient and outpatient settings. The use of this device makes cleaning the site much easier and reduces complications. NICE estimates it could improve care for up to 120,000 people each year.

Available free to eligible sites that do high volumes:

• HeartFlow – advanced image analysis software that creates a 3D model of the coronary arteries and analyses the impact that blockages have on blood flow to rapidly diagnose patients with suspected coronary artery disease. The use of the device can avoid the need for invasive investigations such as coronary angiography, usually carried out under local anaesthetic, where a catheter is passed through the blood vessels to the heart to release a dye before X-rays are taken. NICE estimates it could improve care for up to 35,000 people each year.

Available at 30% discount to eligible sites (as eligible Trusts can reclaim the difference between this product and regular sutures):

• Plus Sutures – a new type of surgical suture coated with Triclosan, that reduces the rate of surgical site infection. 32% of hospital acquired infections are surgical site infections (SSI), most of which can be prevented. Trusts with SSI rates of above 4% in certain clinical specialties are eligible.

In an effort to tackle the problem of missed hospital appointments NHS England is also supporting the use of DrDoctor, a digital tool which enables patients view, change and schedule appointments on their smartphone, in several demonstrator sites. Almost eight million hospital appointments were missed in 2016/17, according to the latest figures. With each hospital outpatient appointment costing the NHS c£120, it means almost £1 billion worth of appointments were missed, equivalent to completing 257,000 hip replacements or 990,000 cataract operations.

We’d also like to urge readers not to forget that the original products that came into effect in April 2017 remain available at either no cost or through Trusts being able to claim a tariff, until April 2019. They are:

• Guided episiotomy EPISCISSORS-60 – guided mediolateral scissors to minimise the risk of obstetric injury, these are now being used in most south London maternity units, including Croydon University Hospital, Epsom and St Helier at both hospital sites, King’s College Hospital, on both the King’s and Princess Royal University Hospital sites and St George’s University Hospital.
• Safe arterial connector Non-injectable arterial connector (NIC) – arterial connecting systems preventing the accidental administration of medicationinto an artery, these are being used successfully at Kingston Hospital.
• VAP prevention PneuX – pneumonia prevention systems which are designed to stop ventilator-associated pneumonia.
• Web based COPD rehab myCOPD – web based application for the self-management of chronic obstructive pulmonary disease. The scheme means that CCGs and Trusts can get the product free for their patients with severe/very severe COPD. It is proving very popular with patients with over 20,000 people having completed the online pulmonary rehabilitation programme to stay well for longer, and usage is currently being explored within SW London.
• Day case prostate surgery UroLift – prostatic urethral lift systems to treat lower urinary tract symptoms of benign prostatic hyperplasia as a day case.

Another great safety innovation

As part of our role in promoting innovations that improve patient safety we are also supporting WireSafe which avoids the never event of a guidewire being inadvertently left in the patient. We know that sadly this never event has occurred in the past year in south London trusts. This ingenious and award-winning device, innovated by the doctor innovator of the NIC, makes it impossible to leave the guidewire in accidently, as you need to use it to open the closing pack. It is not free but is a low cost solution costing the average trust around £3k per year (or £5k for a very large trust).

As an AHSN Network we’ve also built an informative web page devoted to the Innovation and Technology Payment that you and colleagues can view here. Final guidance is awaited from NHS England but will be posted there once available. Free demos and training sessions are also being made available to enable staff to become familiar with and test the devices.

Contact us for support via kate.covill@nhs.net or on 0207 188 9805.

And read further reflections on the tariff here.