The MedTech funding mandate

Introduction to the MedTech funding mandate

The NHS Long Term Plan committed to accelerate the uptake of selected innovative medical devices, diagnostics and digital products to patients faster, by developing the MedTech funding mandate (MTFM) policy that launched on 1 April 2021.

The proposal for this policy was consulted on in December 2019 with patient representatives, NHS providers, commissioners, charities, academics, delivery partners, consultants, independent health providers and industry. Read the consultation report.

The MedTech funding mandate policy received strong support with clear recommendations on the criteria for inclusion of technologies.

Technologies covered by the MedTech funding mandate policy are typically funded by commissioners from their existing allocations. This is deliverable despite NHS resource pressures as the technologies supported are National Institute for Health and Care Excellence (NICE) recommended and meet the criteria to save costs and resources and make a return on investment within three years. Read the guidance for 2022/23.

Impact to Date

2021/22 marked the first year of the MedTech funding mandate policy, where four technologies were supported. We are delighted that patients are, on average, now accessing these technologies in over three quarters of eligible providers. During 2021/22, the monthly number of patients accessing Heartflow increased by 35% and over the year, the innovation created over £2.2 million worth of savings for the NHS. For the same period, the number of providers giving patients regular access to SecurAcath increased by 77%, with associated cost savings increasing from £1.6 million to £2.5 million per year. Gammacore and placental growth factor testing have both seen their usage rise considerably in year, with a further 19 trusts fully adopting Gammacore and eight more offering patients PLGF, despite the removal of national, ring-fenced funding.

Rebecca Sanderson describes how she benefited from access to PLGF:

“In my first two pregnancies I was in and out of hospital and was eventually diagnosed with pre-eclampsia. The frequent monitoring and sometimes long stays in hospital waiting for results meant I had a lot of disruption to my home and work life. ​

Now in my third pregnancy a simple and quick blood test to rule out pre-eclampsia showed that I didn’t need to be admitted to hospital and I was able to go home and be with my family, with the peace of mind that I was okay”.

The MedTech funding mandate has helped the NHS build strong foundations for supporting innovative medtech. In 2022/23 a further seven technologies were introduced, offering further cost savings, improved patient experience, and health outcomes.

How does the policy work

Together with technology suppliers we work with patients and our delivery partners, the academic health science networks (AHSNs) to support NHS organisations to implement the existing innovations, to understand local and regional issues and to share learning from NHS organisations who have already implemented the innovations. This helps to identify barriers to their uptake, such as duplicative procurement processes.

Providers wishing to implement any of the supported technologies should contact their regional AHSN. Alternatively, for more information contact the MedTech Funding Mandate team england.medtechfundingmandate@nhs.net

In addition, you can watch Matt Whitty, Director of Innovation, Research and Life Sciences and Chief Executive of the Accelerated Access Collaborative discussing the MedTech funding mandate policy. The videos provide an overview of the policy and the financial flow between NHS England, healthcare providers and commissioners.

MedTech funding mandate 2023/24

In preparation for 2023/24, the MedTech Funding Mandate policy team have worked with NICE and other key partners to assess all available medical technology guidance and diagnostic guidance. We have also considered current NHS operational pressures and the transition to new commissioning structures with the advent of integrated care systems on 1 July 2022.

We have decided that no additional technologies will be added to the MedTech funding mandate for 2023/24. Instead, we ask that systems prioritise the appropriate adoption of 2021/22 and 2022/23 technologies where this has not yet occurred. All of these technologies offer cost savings and improved patient outcomes and experiences.

This decision will ensure that the MedTech funding mandate does not overburden the sector while it continues to recover from the impacts of COVID-19 and continues to embed integrated care systems and the new commissioning relationships which underpin system working. The Innovation, Research, and Life Sciences group, along with NICE, NHS Supply Chain, and the AHSN network, will continue to support the adoption of the eleven currently supported technologies,

The policy remains in effect and we will be working closely with NICE and our AHSN partners to continue to support the adoption of the eleven technologies currently supported by MTFM.

Technologies covered by the MedTech funding mandate

The MedTech funding mandate launched on 1 April 2021 and has selected a total of eleven technologies for inclusion across two selection rounds. All supported technologies were selected on the basis that they are:

  • Effective: demonstrated through positive NICE medical technology guidance or diagnostic guidance, published by 30 June 2021.
  • Cost-saving within three years of implementation: as demonstrated by NICE modelling and published in a NICE resource impact template.
  • Affordable to the NHS: the NICE budget impact analysis total costs should not exceed £20 million in any of the first three years.

The eleven supported technologies

MedTech funding mandate 2022/23 selection round:

  • 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. NICE guidance 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. NICE guidance MTG29.
  • Rezum: Rezum is a minimally invasive procedure that uses water vapour (steam) to treat benign prostatic hyperplasia. 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 . Rezum effectively alleviates benign prostatic hyperplasia and patients can be treated as outpatients. NICE guidance 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. NICE guidance MTG53.
  • 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 adjacent bone and paranasal sinus structures. This has the potential to reduce the tissue lost compared to traditional functional endoscopic sinus surgery procedures. NICE guidance MTG30.
  • Thopaz+: 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. NICE guidance 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. NICE guidance MTG28.

MedTech funding mandate 2021/22 selection round:

  • Placental growth factor based-testing: Placental growth factor based-testing are blood tests for ruling out pre-eclampsia in pregnant women. Placental growth factor-based tests are intended to be used with clinical judgement and other diagnostic tests, to help rule out suspected pre-eclampsia. This assessment focuses on ruling out pre-eclampsia in the second and third trimesters of pregnancy. NICE guidance DG23.
  • SecurAcath: SecurAcath is a device for securing percutaneous catheters. SecurAcath is used to secure peripherally inserted central catheters (PICCs) and should be considered for any PICC with an anticipated medium to long-term dwell time (15 days or more). NICE guidance MTG34.
  • Heartflow: Heartflow creates a 3D model of a patient’s coronary arteries and assesses the extent and location of blockages. HeartFlow fractional flow reserve – computed tomography estimates fractional flow reserve from coronary CT angiography for patients with stable, recent-onset chest pain, therefore avoiding invasive investigation and treatment. NICE guidance MTG32.
  • gammaCore: gammaCore is a handheld and non-invasive device which stimulates the vagus nerve and is used to treat and prevent the symptoms of severe cluster headaches. It is self-administered by the person or their carer. NICE guidance MTG46.

For any queries, please contact england.medtechfundingmandate@nhs.net. In addition, our FutureNHS collaboration platform will continue to be updated with information and helpful resources on the MedTech funding mandate policy; please email england.medtechfundingmandate@nhs.net to request access.