Benefits of engaging with the Specialised Services Commissioning Innovation Fund (SSCIF)

Andrew Jones, Senior Medical Science Manager| Bristol-Myers SquibbBernie Stocks, Associate Director, Innovation Adoption, Specialised Services | NHS England

Specialised Services Innovation Bernie Stocks

13 June 2013

Specialised Services Innovation ‘job card’

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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/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_131784.pdf

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4135216.pdf

http://mandate.dh.gov.uk/

NHS | ABPI | 13 04 13

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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 monthsCan involve collaboration between commissioners, clinicians, patients,

innovators and the commercial sector5

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

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• 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 ImpactEffectiveness Testing

• Post launch evaluationInnovation Implementation

• Early adopter implementation

Early Implementation

Ado

ptio

n

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

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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