Medical technologies guidance: making NHS pathways more efficient and delivering quality for patients

We develop medical technologies guidance on products which offer benefits for patients and help the NHS use resources more efficiently.

We produce medtech innovation briefings, commissioned by NHS England in support of the 5 Year Forward View, to support local decision-making by clinicians and managers and avoid the need for multiple local evaluation of promising technologies.

The medical technologies we evaluate include devices,  such as those implanted during surgical procedures, diagnostic tests  used to detect or monitor medical conditions, digital health technologies such as mobile apps, or combinations of these.

This year we developed medical technology guidance on topics such as prostate disease, catheter infection and sickle cell disease. We published 36 medtech innovation briefings (MIBs).

Liver damage device could help thousands avoid biopsy

Thousands of people could be spared an invasive procedure to diagnose and monitor liver damage, following guidance we produced in September 2015.

The guidance recommends Virtual Touch Quantification (VTq) for use in the NHS and for people with chronic hepatitis B or C who need liver fibrosis assessment.

Liver fibrosis occurs when there is a lot of scar tissue in the liver, and makes the liver’s texture stiff. The scar tissue can result from damage to liver cells caused by infections such as chronic hepatitis B or C, inflammation and injury.

VTq is a piece of software that assesses the stiffness of the liver. It does this through readings of a high intensity ultrasound wave that is transmitted through the liver.

The wave travels at different speeds through liver tissue depending on whether the liver is flexible and healthy, or whether it is stiff due to fibrous scar tissue caused by damage.

VTq is painless and could even be safer than liver biopsy. It could also save around £434 per patient compared with liver biopsy, and £53 per patient compared with another procedure called transient elastography.

Welcoming the NICE guidance, Andrew Langford, Chief Executive of the British Liver Trust, said:

“Liver disease is the third main cause of premature death and of the top five causes is the only one that continues to increase. It is vital that early diagnosis is increased so that each person can make the necessary lifestyle changes or receive treatments that will prevent progression and possibly reverse or cure their disease.

“VTq is an invaluable addition to making diagnosis and on-going monitoring as easy and patient centred as possible, so it’s good that the NICE guidance encourages its use.”

Sickle cell treatment could save NHS millions

A device for managing sickle cell disease which makes treatment easier and quicker for patients was recommended by our guidance in March 2016.

We approved the Spectra Optia Aphresis System for automated red blood cell exchange in patients with sickle cell disease who need regular transfusion. We estimate the technology could save the NHS in England around £13 million each year.

Sickle cell disease is an inherited genetic disease affecting red blood cells. The cells are a crescent – or sickle – shape instead of the normal round disc shape, affecting the cell’s ability to carry oxygen and move around the body.

Symptoms may include intense pain and severe anaemia, and the condition can cause damage to major organs and infections, and life-threatening complications.

Neil Westerdale, sickle cell advanced nurse practitioner for adults at Guy's and St Thomas’ hospital in London, talks about the disease and benefits of treatment with the Spectra Optia System.

There are between 12,500 – 15,000 people with sickle cell disease in the UK, with an estimated 240,000 genetic carriers. It is more prevalent among people of African and African-Caribbean descent, but it can affect any ethnic group.  There is no routine cure for sickle cell disease but patients can be supported to manage the condition.

The Specta Optia device automatically replaces sickle red blood cells with healthy red blood cells in people with the disease. It is faster to use and patients need the process less often than manual red blood cell exchange.

John James, Chief Executive of the Sickle Cell Society, said:

“The Sickle Cell Society welcomes the NICE guidance on Spectra Optia. The Society has worked hard to improve access to this technology, and participated in the process every step of the way with NICE to help produce the guidance.  Many people living with sickle cell would benefit from automated red cell exchange and guidance will enable more and more patients to access this treatment.

“We anticipate that this guidance will help more hospitals adopt the technology, saving patients from costly and often exhausting travel.”