Five-year implementation strategy for Hybrid closed loop technologies in England

On January 22, 2024, NHS England published a 5-year implementation strategy for Hybrid closed loop (HCL) technologies following the publication of the NICE technology appraisal (TA943). Normally, commissioners and providers are expected to implement NICE TA recommendations within three months. NICE agreed to extend the standard period to 5 years to allow the NHS time to train and build specialist competencies within the clinical workforce and procure HCL technologies at cost-effective prices.

The implementation strategy is primarily aimed at integrated care boards (ICB) leads, trust clinical leads, regional diabetes leads, and clinical network leads. Key elements of the implementation strategy include workforce capacity and competencies, patient and professional education, commercial requirements, resources to support mobilization, ICB reimbursements for HCL technologies, as well as activity and outcomes reporting.

ICBs are responsible for the implementation of HCL and ensuring equitable access for their local population.

NHS England will contribute to the costs of HCL and offer reimbursement funding:

• From 2024/25, NHS England will make available capped funding to all ICBs, from which they can request reimbursement for 75% of the estimated incremental costs of HCL (the cost of the technology and operational delivery of the service);
• Each ICB’s maximum funding will be calculated using data from the National Diabetes Audit and National Paediatric Diabetes Audit on the total eligible population. NHS England will review HCL activity and make retrospective quarterly reimbursements to ICBs as Service Development Funding. Where ICBs are not claiming the maximum amount in a year, NHS England may, by exception and with the agreement of regional teams, reallocate underspend to other ICBs;

ICBs must meet specific criteria to receive HCL reimbursement (e.g., technologies must be purchased from the national framework of HCL technologies hosted by NHS Supply Chain once the framework is established in the 2024/25 financial year).

NHS England also released a £2.5 million HCL mobilization fund in December 2023 (£60,000 per ICB) to support activities defined in the implementation strategy.

See the full details here.

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