Medical Technology Group

The Medical Technology Group (MTG) is a not for profit organisation in the United Kingdom comprising patient groups, research charities and medical device manufacturers. Its stated aim is to "work together to improve patient access to effective medical technologies". The Group launched in 2001.[1]

Membership

Current members of the MTG are:

Research

Innovation adoption in the NHS

In its report Our NHS: A Spotlight on the Innovation Landscape, published in January 2020, the MTG assessed the mechanisms for innovation and technology within the NHS, and whether they foster an environment that delivers timely treatments to patients and takes full advantage of the health technology on offer.[2] The report evaluated the key innovation organisations, based on factors such as how they perform, interact and operate with one another and considered the changes that have taken place since the 2016 Déjà Review report, assessing whether the development of the Accelerated Access Review took the recommendations made in this report into account and avoided previous mistakes.[3]

CCG treatment rationing

Over half of clinical commissioning groups restrict access to cataract surgery, research by the Medical Technology Group into CCGs' lists of 'Procedures of Limited Clinical Value' in October 2018 revealed.[4] Other findings were that almost half of CCGs limit access to hernia repair and many take a 'watchful waiting' approach, which can increase emergency cases and lead to worse patient outcomes. In addition, 78 CCGs restrict hip and knee replacement, despite the surgery being proven to be effective in keeping people mobile since over half a century. A further 12 CCGs refuse to provide patients with continuous glucose monitoring, while seven only provide it with an individual funding request. The Royal National Institute for Blind People (RNIB) described the findings as "shocking", while the Royal College of Surgeons said that "It is wrong for commissioning groups to label operations for hip and knee replacements, and hernia surgery, as of limited value – thereby delaying or denying surgery to patients in pain."[5][6] In 2019 the Medical Technology Group launched a campaign 'Ration Watch' calling for a national body to scrutinise decisions by individual CCGs and ensure patient access to treatments is consistent across the country.[7]

STPs and the use of technology

Nine out of ten regional NHS plans are failing to pay enough attention to the role of medical technology, a report by the Medical Technology Group report found in November 2018. All 44 regional STP plans were analysed in the report STPs and the use of technology, which concluded that the NHS is risking missing out on the opportunity to benefit from the use of innovative medical technology.[8] Seven recommendations for ensuring healthcare systems assess, procure, commission and deliver technology-based treatments effectively are set out in the report.[9] Writing on the BMA website, MTG Chair Barbara Harpham said: "Until it puts an end to its perverse incentives, the NHS will never truly embrace technology and realise its benefits."[10]

Keeping Britain Working: How medical technology can help reduce the cost of ill health to the UK economy

In November 2017, The Medical Technology Group launched its second major study, Keeping Britain Working – How medical technology can help reduce the cost of ill health to the UK economy.[11] Building on the Work Foundation's 2011 study,[12] the report explores the societal and economic impact of eight technologies: hip replacements; implantable cardiac defibrillators (ICDs); insulin pumps; diagnostics, including sepsis; fibroid embolisation; pain management; wound care; and coronary angioplasty. The report concluded that £476 million in savings per year could be generated from the use of eight technologies in reduced long-term health costs and benefit payments.[13]

The North-South NHS divide: how where you are – not what you need – dictates your care

A review of all 209 clinical commissioning groups (CCGs) in England – published in August 2017 – revealed wide variation in waiting times and access to medical technology for patients. The study The North-South NHS divide: how where you are - not what you need - dictates your care examined five clinical areas in NHS 18 Week Referral to Treatment and NHS Atlas of Variation data.[14] It found that nine out of ten of the poorest performing CCGs were based in the south of England and that almost three times more patients were waiting longer than 18 weeks for treatment compared with November 2012. The report made seven recommendations for improvement including greater transparency so that patients can compare the performance of their local health service and inspections of the poorest performing CCGs by NHS England.[15][16]

Déjà Review – what lessons can be learned from the past?

In June 2016, the Medical Technology Group published its report Déjà Review – what lessons can be learned from the past?.[17] The report identified 17 different organisations or initiatives that have been launched with the aim of promoting innovation in the NHS over the previous ten years. In Déjà Review, the MTG noted that the NHS has historically and consistently failed to apply any learnings from the previous reviews, including 2011's much-quoted Innovation, Health and Wealth (IHW).[18]

Unplanned admissions

In 2015 the Medical Technology Group contacted every acute trust and clinical commissioning group in England to identify the level of unplanned or emergency hospital admissions for urology, diabetes and heart failure. The research found that unplanned and emergency hospital admissions account for more than a third of all hospital admissions – 5.4 million in total – and two-thirds of all hospital bed days. It also found that the NHS spent £434 million in 2013/14 treating over 180,000 hospital patients with an unplanned admission for a urinary tract infection; unplanned admissions owing to diabetic complications cost over £200 million each year. Additional findings were that each NHS trust handles on average over 100 deaths each year from congestive heart failure, but with regional differences in approach and success rates: for example, 66% of presenting heart patients in the Southwest were treated in hospital compared to just 16% in the West Midlands.[19][20]

Innovation, Health & Wealth Scorecard

In June 2015 the MTG published its review of the 2011 Innovation, Health & Wealth report by NHS Improvement & Efficiency, Innovation and Service Improvement. The scorecard reviewed progress against the six areas identified by the NHS as those where clinical commissioning groups and acute trusts could improve patient care through high impact innovations.[21] The report revealed a very mixed picture, with both CCGs and trusts in some areas performing much worse than others, and some regions of the country drastically underperforming.[22]

Infection control

Following a freedom of information request to all NHS acute trusts in England, in September 2014 the MTG published a report: Infection Prevention and Control – Combatting a problem that has not gone away that revealed that the majority of Trusts were unaware of the full scale or the operational and financial impact of five common infections: sepsis; catheter-associated urinary tract infections; catheter-related blood infections; ventilator-associated pneumonia; and norovirus. The MTG called on the government to develop a strategy for using technology for infection prevention and control.[23]

Hip and knee surgery

In November 2013, the MTG published a report into waiting times for knee and hip replacements on the National Health Service. The report, Hip and Knee Surgery: Combating Patient Lotteries, reviewed ten years of government data on knee and hip replacement, and data from freedom of information requests to acute NHS hospital trusts in England.[24] The report suggested that patient experiences vary significantly according to the financial calendar and where they live.[25][26][27][28][29]

Work Foundation report

In November 2011, The Work Foundation published a report, Adding Value: The Economic and Societal Benefits of Medical Technology,[30] funded by a research grant from the MTG. The report, which was launched in the House of Commons, identified three key areas of benefits from medical technologies:[31][32]

  • Improvements in health care (quality, efficiency and the empowerment of patients);
  • Improving quality of life and independent living (reducing fears and anxiety, increasing flexibility, and reducing the need for informal care and the burden on informal caregivers);
  • Labour market participation and productivity (increasing labour market participation, retaining skills and improving productivity).

Uterine artery/fibroid embolisation (UFE)

In 2011 the MTG and patient support group FEmISA published a report, The provision of and access to Uterine Artery/Fibroid,[33] a less invasive treatment for fibroids for women. The report, which was welcomed by the British Society of Interventional Radiologists, highlighted a lack of coherent commissioning in England, despite National Institute for Health and Care Excellence clinical guidelines recommending UFE as a first-line treatment for symptomatic fibroids.[34][35]

Insulin pump provision

In 2010 the MTG made a freedom of information request to primary care trusts in England on the provision of insulin pumps to patients with Type 1 diabetes. It found the average to be 3.9 per cent compared to the 12 per cent benchmark recommended by the National Institute for Health and Clinical Excellence. The findings were the subject of an early day motion tabled by Adrian Sanders MP on 9 December 2010.[36]

Medical technology

In 2004, the MTG's report Making the Economic Case for Medical Technology suggested that increasing the provision of medical technology can "help patients better manage their conditions" and lead a "longer and relatively healthy life".[37] It also suggested that by making greater use of technology there are cost benefits for the National Health Service. The report was the subject of an early day motion tabled by Ian Gibson MP. The motion was signed by 30 Members of Parliament.[38]

Organisation

The MTG is chaired by Barbara Harpham, National Director of Heart Research UK. She has been quoted as saying that the UK lags behind other European countries in the take-up of medical technology.[39][40][41] [42]

References
  1. "Early Day Motion 216, 2000-01". UK Parliament. Retrieved 26 November 2013.
  2. https://mtg.org.uk/wp-content/uploads/2020/01/Our-NHS-A-Spotlight-on-the-Innovation-Landscape-FINAL-PDF.pdf
  3. Barbara, Harpham (4 February 2020). "The innovation buck stops with you, Mr Hancock". Health Business. Retrieved 27 February 2020.
  4. http://www.rationwatch.co.uk/ccgs/
  5. Laura, Donnelly (20 March 2019). "More than half of NHS authorities rationing cataract operations". The Telegraph. Retrieved 20 March 2019.
  6. Brennan, Sharon; Reid, Jenna (20 March 2019). "Revealed: CCGs restricting access to basic treatments". Health Service Journal (HSJ). Retrieved 20 March 2019.
  7. http://www.rationwatch.co.uk
  8. https://mtg.org.uk/wp-content/uploads/2018/11/STPs-and-the-use-of-technology-low-res.pdf
  9. "NHS regional plans not valuing medical tech". Health Business. 15 November 2018. Retrieved 15 November 2018.
  10. Harpham, Barbara. "The not so white heat of NHS technology". BMA Free for All blog. BMA. Retrieved 3 January 2019.
  11. http://www.mtg.org.uk/wp-content/uploads/2017/11/Keeping-Britain-Working-Report-web.pdf
  12. http://www.mtg.org.uk/wp-content/uploads/2017/01/Adding-Value-The-Economic-and-Societal-Benefits-of-Medical-Technology.pdf
  13. "NHS is 'missing a trick' by opting for cheaper treatment options, report warns". Building Better Healthcare. HPCi Media Limited. Retrieved 3 January 2018.
  14. http://www.mtg.org.uk/wp-content/uploads/2017/08/The-North-South-NHS-divide-how-where-you-are-not-what-you-need-dictates-your-care-FINAL-low-res.pdf
  15. Davis, Nicola (15 August 2017). "NHS waiting times and treatment access are a postcode lottery, report warns". Guardian News & Media. Retrieved 15 August 2017.
  16. Pym, Hugh (2017-08-15). "How bad is the NHS postcode lottery?". BBC. Retrieved 15 August 2017.
  17. https://drive.google.com/file/d/0B60cHNIWGkbiT0dTelYtQUd1c0k/view
  18. "Wasteful NHS reports could pay for drugs". The Telegraph. Retrieved 2016-06-23.
  19. "Better use of technology could slash A&E costs". Arryhthmia Watch. British Journal of Cardiology. Retrieved 7 December 2015.
  20. Health Business (April 2016). "Accessing all areas of medical technology" (Volume 6.2). Public Sector Information Ltd. Retrieved 29 April 2016.
  21. http://www.mtg.org.uk/press-releases/innovation-health-and-wealth-scorecard
  22. Harpham, Barbara (August 2015). "Innovation adoption: stuck in the slow lane?". Clinical Services Journal. Retrieved 28 September 2015.
  23. Adrian, O’Dowd (15 September 2014). "British Medical Journal". BMJ. Retrieved 19 September 2014.
  24. http://www.mtg.org.uk/images/Spotlight/Hip_and_Knee_Replacements_-_Combating_Patient_Lotteries.pdf
  25. Kmietowicz, Zosia (6 November 2013). "Commissioners are restricting referrals for hip and knee surgery, says report". BMJ. Retrieved 25 November 2013.
  26. Campbell, Denis (6 November 2013). "A&E overcrowding may cost lives, emergency doctors warn". The Guardian. Retrieved 25 November 2013.
  27. "Patients must get fairer access to medical technology". The Information Daily. 7 November 2013. Retrieved 25 November 2013.
  28. "Patients facing hip-knee 'lottery'". Yahoo News (via Press Association). 6 November 2013. Retrieved 25 November 2013.
  29. "Patients facing hip-knee 'lottery'". London Evening Standard. 6 November 2013. Retrieved 25 November 2013.
  30. http://www.theworkfoundation.com/DownloadPublication/Report/296_Adding%20value%20-%20The%20Economic%20and%20Societal%20Benefits%20of%20Medical%20Technology.pdf
  31. "Work Foundation Report – Adding value: The Economic and Societal Benefits of Medical Technology". British Orthopaedic Association. Retrieved 25 November 2013.
  32. Rennard, Lord. "The long term benefits of medical technology must be recognised". Politics Home. Retrieved 25 November 2013.
  33. http://www.mtg.org.uk/files/UFEResearchReport.pdf
  34. "Significant variation in numbers of women in England undergoing uterine fibroid embolisation to treat fibroids". Right Care. Retrieved 25 November 2013.
  35. "Your first choice: the provision of and access to UFE". The King's Fund. Retrieved 25 November 2013.
  36. "Early day motion 1167". UK Parliament. Retrieved 27 November 2013.
  37. http://www.patientsorganizations.org/attach.pl/290/69/Economic%20Benefits%20of%20Medical%20Technology%20-%20MTG,%20June%202004.pdf
  38. "Early day motion 1865". UK Parliament. Retrieved 27 November 2013.
  39. "Fear of cuts to NHS medical technology budgets". BBC News. 25 November 2009. Retrieved 25 November 2013.
  40. "NHS 'must boost use of technology' or risk falling behind". Nursing Times. 25 November 2009. Retrieved 25 November 2013.
  41. "Five minutes with ... the chair of the Medical Technology Group". The Guardian. 7 February 2014. Retrieved 2 April 2014.
  42. Nigel, Hawkes (8 October 2015). "The Times". Raconteur. Retrieved 15 October 2015.
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