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Benefits of engaging with the
Specialised Services
Commissioning Innovation
Fund (SSCIF)
Andrew Jones, Senior Medical Science Manager| Bristol-Myers Squibb
Bernie Stocks, Associate Director, Innovation Adoption, Specialised Services |
NHS England
Specialised Services Innovation
Bernie Stocks
13 June 2013
Specialised Services Innovation ‘job card’
3
IHW:
Create an
innovation
fund
Legal Duty to
promote
research and
innovation
NHS
England
Ambition:
equity&
excellence-
specialised
care
The
Mandate
The Carter
Review
http://www.dh.gov.uk/pro
d_consum_dh/groups/dh
_digitalassets/document
s/digitalasset/dh_131784
.pdf
http://www.dh.gov.uk/prod_consu
m_dh/groups/dh_digitalassets/@
dh/@en/documents/digitalasset/d
h_4135216.pdf
http://mandate.dh.gov.uk/
NHS | ABPI | 13 04 13
4
Specialised Services
Commissioning Innovation
Fund (SSCIF)
SSCIF
For innovations:
Which are new to NHS specialised services or applied in a way that is new
to NHS specialised services
That have shown promise of delivering an improvement in the quality or
cost and affordability of service delivery
Which have a clearly defined value proposition and, if a service or product,
have reached entry levels of safety ready for evaluation in clinical practice.
SSCIF Evaluation Projects
Will be rapid, typically ranging from six to 18 months
Can involve collaboration between commissioners, clinicians, patients,
innovators and the commercial sector
5
SSCIF – Prime Objective
• To generate missing data and information on the impact of the innovation on:
 Quality,
 Cost and affordability and
 NHS activity levels
…which can be used to inform commissioning policy
• By rapidly evaluation in a clinical, healthcare service setting, innovative
models of care, pathways, approaches, devices, technologies, products and
medicines with the potential to deliver high impact change for NHS
specialised services
6
• Idea
• Design
• Prototype
Invention
• Safety Testing
• Effectiveness Evaluation
• Effectiveness Testing
• Innovation Implementation
• Early Implementation
• Procurement
• Secondary Implementation
Adoption
• Voluntary Diffusion
• Advisory Diffusion
• Mandatory Diffusion
Diffusion
Focus
of
SSCIF
SSCIF Focus within the stages of Innovation
SSCIF will test innovations at these stages:
• Proof of ConceptEffectiveness
Evaluation
• Proof of Impact
Effectiveness
Testing
• Post launch evaluation
Innovation
Implementation
• Early adopter
implementation
Early
Implementation
Adoption
SSCIF - Benefits
• Creation of an evidence base for use in national commissioning decisions
which will result in rapid, widespread adoption of proven innovations in the
NHS.
• Earlier access to innovative care for patients.
• Increased value for money to the NHS.
• Increase knowledge of offer and impact of individual innovations/products
9
Process
decision
Simple on-line Step 1: Self-Assessment
Step 3: Detailed Submission (Table top expert review
Step 2: Qualifying Submission Form (CRG Chair reviews)
Process
• Open to healthcare staff, manufacturers, clinicians, researchers, patient
groups and commissioners.
• Submissions can be made anyone at Steps 1 and 2, but by Step 3, a
practising Lead Healthcare Practitioner employed by a healthcare
organisation that supports the generation of wealth in the UK will need to
sponsor and agree to lead the project.
• Manufacturers and others can form alliances with health staff to do this.
Medical Directors of the Healthcare Lead’s organisation will need to endorse
the submission.
Funded Projects - documents and requirements
decisionFunded SSCIF Evaluation Projects will have a Service Level Agreement
with a contract schedule taken from the Step 3: Detailed Submission
Form detailing the key activities, key milestones, intended outcomes and
key performance indicators.
Lead Applicants will be provided with sample templates for:
 A project initiation document
 A protocol for local ethical approval
 Informed Consent and patient participation
 Data set for Patient Information Leaflets
 Headings for final report including final products, factors for success
etc.
SSCIF Next Steps
Innovation Health and Wealth
• UK Plan for Growth March 2011
– Challenged NHS CE to review adoption and diffusion of
innovation
• Prompted the NHS CE Review
– Asked major stakeholders what might be done to
accelerate the spread of innovations in the NHS
– Consultation across NHS, Government, Industry,
Academia and Patient Groups
– 310 responses received; 28% from industry (Incl Med Tech)
– 17% of respondents identified the need for innovation
funds (including a specific fund for Specialised Services)
• Resulted in IHW (Dec 2011)
– 31 Actions to drive the adoption and diffusion of innovation
Reason for the SSCIF
• Many innovations with promise available to the NHS
– But often languishing at a local/regional level
– No widespread uptake due to lack of commissioning
evidence
• Evidence Generation in Specialised Services often
difficult
– Low volume
– Hard to achieve levels of evidence similar to those
generated by RCTs
– Even data (incl. RCTs) sufficient for MA are often not
enough to convince commissioners of the innovation’s
value in clinical practice
Ethos of the SSCIF
• Aid accelerated adoption and diffusion of transformational
innovations
– Generate evidence on the value of promising innovations
that are available for use in the NHS
– To enable evidence based commissioning decisions to be made
– Make use of New Structure
– National commissioning decisions for specialised services
– Set a paradigm for adoption and diffusion of innovation in a
clinically led fashion
Another Hurdle?
• No!!
• In the past
– Drugs not considered by NICE or not recommended due to
lack of evidence
– Commissioning considered independently by 10 SCGs
– Each following a different process (rarely evidence generating)
– Potential for 10 different decisions
• Now
– 1 National decision on specialised services commissioning
– Must be based on robust evidence
– How can this be obtained if not a NICE topic or not recommended
due to lack of evidence
• The SSCIF is a real opportunity
Silo Busting
• SSCIF Evaluation Projects will:
– Look at complete patient pathway, taking into account:
– Impact of the innovation on outcomes; and
– Cost and efficiency; and
– Activity levels
across all parts of the pathway
– Consider:
– Societal Impacts
– Gaps in service provision (degree of unmet need)
– Generate evidence to fill data gaps that are preventing
commissioning
– Data gaps on effectiveness and costs in the NHS
Real Opportunity for Partnership
• The SSCIF aims to generate evidence that is:
– Is needed by NHS England for national commissioning decisions
in the new structure
– Could benefit the manufacturer once generated
• Therefore generation of evidence should be funded jointly
– NHS England has set up a fund (SSCIF) to generate the
information it needs for all innovations
– Manufacturers should not rely wholly on NHS funding to generate
data on their products (State Aid)
– So for commercial applications to the SSCIF, the evaluation
projects will need to be jointly funded by the applicant and by the
SSCIF
Unrivalled potential
• A successful evaluation project will result in
– National Commissioning Policy
– potentially a National commissioning decision.
– This is unlike anything seen before in specialised services
• The partnership ethos will extend to commissioning
arrangements post SSCIF evaluation
– Exclusivity terms
– Discounted purchase price

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Benefits of engaging with the Specialised Services Commissioning Innovation Fund

  • 1. Benefits of engaging with the Specialised Services Commissioning Innovation Fund (SSCIF) Andrew Jones, Senior Medical Science Manager| Bristol-Myers Squibb Bernie Stocks, Associate Director, Innovation Adoption, Specialised Services | NHS England
  • 3. Specialised Services Innovation ‘job card’ 3 IHW: Create an innovation fund Legal Duty to promote research and innovation NHS England Ambition: equity& excellence- specialised care The Mandate The Carter Review http://www.dh.gov.uk/pro d_consum_dh/groups/dh _digitalassets/document s/digitalasset/dh_131784 .pdf http://www.dh.gov.uk/prod_consu m_dh/groups/dh_digitalassets/@ dh/@en/documents/digitalasset/d h_4135216.pdf http://mandate.dh.gov.uk/ NHS | ABPI | 13 04 13
  • 5. SSCIF For innovations: Which are new to NHS specialised services or applied in a way that is new to NHS specialised services That have shown promise of delivering an improvement in the quality or cost and affordability of service delivery Which have a clearly defined value proposition and, if a service or product, have reached entry levels of safety ready for evaluation in clinical practice. SSCIF Evaluation Projects Will be rapid, typically ranging from six to 18 months Can involve collaboration between commissioners, clinicians, patients, innovators and the commercial sector 5
  • 6. SSCIF – Prime Objective • To generate missing data and information on the impact of the innovation on:  Quality,  Cost and affordability and  NHS activity levels …which can be used to inform commissioning policy • By rapidly evaluation in a clinical, healthcare service setting, innovative models of care, pathways, approaches, devices, technologies, products and medicines with the potential to deliver high impact change for NHS specialised services 6
  • 7. • Idea • Design • Prototype Invention • Safety Testing • Effectiveness Evaluation • Effectiveness Testing • Innovation Implementation • Early Implementation • Procurement • Secondary Implementation Adoption • Voluntary Diffusion • Advisory Diffusion • Mandatory Diffusion Diffusion Focus of SSCIF SSCIF Focus within the stages of Innovation
  • 8. SSCIF will test innovations at these stages: • Proof of ConceptEffectiveness Evaluation • Proof of Impact Effectiveness Testing • Post launch evaluation Innovation Implementation • Early adopter implementation Early Implementation Adoption
  • 9. SSCIF - Benefits • Creation of an evidence base for use in national commissioning decisions which will result in rapid, widespread adoption of proven innovations in the NHS. • Earlier access to innovative care for patients. • Increased value for money to the NHS. • Increase knowledge of offer and impact of individual innovations/products 9
  • 10. Process decision Simple on-line Step 1: Self-Assessment Step 3: Detailed Submission (Table top expert review Step 2: Qualifying Submission Form (CRG Chair reviews)
  • 11. Process • Open to healthcare staff, manufacturers, clinicians, researchers, patient groups and commissioners. • Submissions can be made anyone at Steps 1 and 2, but by Step 3, a practising Lead Healthcare Practitioner employed by a healthcare organisation that supports the generation of wealth in the UK will need to sponsor and agree to lead the project. • Manufacturers and others can form alliances with health staff to do this. Medical Directors of the Healthcare Lead’s organisation will need to endorse the submission.
  • 12. Funded Projects - documents and requirements decisionFunded SSCIF Evaluation Projects will have a Service Level Agreement with a contract schedule taken from the Step 3: Detailed Submission Form detailing the key activities, key milestones, intended outcomes and key performance indicators. Lead Applicants will be provided with sample templates for:  A project initiation document  A protocol for local ethical approval  Informed Consent and patient participation  Data set for Patient Information Leaflets  Headings for final report including final products, factors for success etc.
  • 14. Innovation Health and Wealth • UK Plan for Growth March 2011 – Challenged NHS CE to review adoption and diffusion of innovation • Prompted the NHS CE Review – Asked major stakeholders what might be done to accelerate the spread of innovations in the NHS – Consultation across NHS, Government, Industry, Academia and Patient Groups – 310 responses received; 28% from industry (Incl Med Tech) – 17% of respondents identified the need for innovation funds (including a specific fund for Specialised Services) • Resulted in IHW (Dec 2011) – 31 Actions to drive the adoption and diffusion of innovation
  • 15. Reason for the SSCIF • Many innovations with promise available to the NHS – But often languishing at a local/regional level – No widespread uptake due to lack of commissioning evidence • Evidence Generation in Specialised Services often difficult – Low volume – Hard to achieve levels of evidence similar to those generated by RCTs – Even data (incl. RCTs) sufficient for MA are often not enough to convince commissioners of the innovation’s value in clinical practice
  • 16. Ethos of the SSCIF • Aid accelerated adoption and diffusion of transformational innovations – Generate evidence on the value of promising innovations that are available for use in the NHS – To enable evidence based commissioning decisions to be made – Make use of New Structure – National commissioning decisions for specialised services – Set a paradigm for adoption and diffusion of innovation in a clinically led fashion
  • 17. Another Hurdle? • No!! • In the past – Drugs not considered by NICE or not recommended due to lack of evidence – Commissioning considered independently by 10 SCGs – Each following a different process (rarely evidence generating) – Potential for 10 different decisions • Now – 1 National decision on specialised services commissioning – Must be based on robust evidence – How can this be obtained if not a NICE topic or not recommended due to lack of evidence • The SSCIF is a real opportunity
  • 18. Silo Busting • SSCIF Evaluation Projects will: – Look at complete patient pathway, taking into account: – Impact of the innovation on outcomes; and – Cost and efficiency; and – Activity levels across all parts of the pathway – Consider: – Societal Impacts – Gaps in service provision (degree of unmet need) – Generate evidence to fill data gaps that are preventing commissioning – Data gaps on effectiveness and costs in the NHS
  • 19. Real Opportunity for Partnership • The SSCIF aims to generate evidence that is: – Is needed by NHS England for national commissioning decisions in the new structure – Could benefit the manufacturer once generated • Therefore generation of evidence should be funded jointly – NHS England has set up a fund (SSCIF) to generate the information it needs for all innovations – Manufacturers should not rely wholly on NHS funding to generate data on their products (State Aid) – So for commercial applications to the SSCIF, the evaluation projects will need to be jointly funded by the applicant and by the SSCIF
  • 20. Unrivalled potential • A successful evaluation project will result in – National Commissioning Policy – potentially a National commissioning decision. – This is unlike anything seen before in specialised services • The partnership ethos will extend to commissioning arrangements post SSCIF evaluation – Exclusivity terms – Discounted purchase price

Notas del editor

  1. Innovation Health and Wealth DH, Dec 2011 included a recommendation to the NHS CB to create an innovation fund for specialised servicesNHS CB Legal Duty to promote research and innovation - including invention , adoption and diffusion of good practice NHS CB ambition to achieve equity and excellence in the provision of specialised care and treatment through excellent commissioning, accelerated by the opportunity to manage new innovations and introduction of technologies in a systematic way that is patient centredThe Mandate: from the Government to the NHS CB to free local organisations and staff to innovate and improveRequirement on the NHS CB to design the commissioning of specialised services in line with direction set out by Sir David Carter’s 2006 independent review
  2. Innovations which are in the invention or diffusion stages, including research, are out of scope.Innovations which are in the first four parts of the adoption phase as shown here are in scope.
  3. Promise = potential to deliver high impact change if adopted Nationally
  4. Value = improved outcomes, cost savings, activity impacts savings.Available for use – i.e. Licenced – off label considered but not unlicensedPrescribed services (> old spec servs – includes services that need to be carried out at specialist centres) commissioned at a national level
  5. SCG decisions often not even evidence based, but based on clinical feel an local affordabilityOpportunity to partner with the NHS to generate the evidence needed to inform robust commissioning decisions that will lastProjects could study sub-groups for whom better outcomes are likely - unlike a NICE appraisal which mainly looks at the data for the broader licensed indication
  6. In short the SSCIF will determine the true value of an innovation specific to its use in the NHS
  7. This meeting is about partnership and the SSCIF epitomises thisWhy is joint investment the answer – State Aid issuesFunding from applicant not necessarily monetary – can be resource, product etc. Joint investment proposal to be made by applicant and will be considered during the review of the application – and if application reached the final stage will be discussed with the Fund decision panel.In additio
  8. SSCIF is looking for high impact innovations and any evaluation which supports the promise of the evaluation will be very attractive to NHS England Board and acting an such a commissioning policy will be high priority.Exclusivity terms and discounted purchase price – equate to a volume discount and will be discussed with the SSCIF panel either upfront or post evaluation project (as project may be negative)Risks – negative evaluation project will result in a negative commissioning policy and complete loss of market Intermediate projects may identify sub-groups which will be the focus of a commissioning policyTHE SSCIF Team and the relevant CRG will decide on the scope of any commissioning policy.Partnership will extend to commissioning arrangements post SSCIF evaluation