UK

On April 19, 2021, NICE has presented a new 5-year strategic plan at the virtual event. NICE provided clarifications and answered the questions on its strategy for 2021 to 2026 published in April that identified key trends and four strategic pillars indicating the significant changes NICE wants to make.

On March 31, 2021, NICE published Technology Appraisal Guidance on selective internal radiation therapies (SIRT) for treating hepatocellular carcinoma (HCC). Technology Appraisal is the only NICE program that has a direct link with the acceptance of technologies by payers. Payers need to implement the recommended technologies within three months after the publication of the guidance. Medical devices are very rarely evaluated within the Technology Appraisal program. SIR-Spheres and TheraSphere were recommended to treat unresectable advanced HCC under certain conditions, while QuiremSpheres was not recommended.

Healthcare Improvement Scotland develops HTAs and clinical guidelines to support decision-making. In the first quarter of 2021, Healthcare Improvement Scotland published assessments of targeted screening for early lung cancer in adults at high risk, gammaCore for cluster headache, and other topics, which mostly concern eHealth technologies.

In March 2021, the National Institute for Health and Care Excellence (NICE) published four new Interventional Procedure Guidance (transcervical ultrasound-guided radiofrequency ablation for symptomatic uterine fibroids, extracorporeal whole liver perfusion, free-functioning gracilis transfer to restore upper limb function, cytoreduction surgery with hyperthermic intraoperative peritoneal chemotherapy), two Medical Technologies Guidance (Danis stent for acute oesophageal variceal bleeding, Alpha-Stim AID for anxiety disorders), two Medtech Innovation Briefings (Sonata system for symptomatic uterine fibroids, Butterfly iQ+ for diagnostic ultrasound), and one Diagnostic Guidance (QAngio XA 3D QFR and CAAS vFFR imaging software for assessing coronary stenosis). Also, five clinical guidelines were updated.

In March 2021, 32 NHS trusts received funding through the NHSX Digital Aspirant program, which was initiated in 2020, and already supports 27 NHS trusts for their digital transformation. Seven of the newly added NHS trusts will receive up to £6 million over the next three years, while the remaining 25 are receiving funding of £250,000 to develop their digital strategy and business case.

On March 17, 2021, NHS Digital released HRG4+ 2021/22 Local Payment Grouper. In general, there were no significant changes in the HRG logic for 2021/22, and no new HRGs were introduced. Two new ICD-10 codes for COVID-19 were incorporated into the grouping logic in addition to three codes already included in the consultation grouper. Furthermore, three new Main Speciality Codes (MSC) and 25 new Treatment Function Codes (TFC), which were introduced in April 2020, became mandatory to use in Grouper from April 2021. These codes concern a wide specter of areas of care.

On March 22, 2021, NHS England and NHS Improvement released 2021/22 National Tariff Payment System consultation documents and launched an online feedback survey that closes on April 30, 2021. The main proposed change is introducing an "Aligned Payment and Incentive" (API) approach, comprising fixed and variable elements, for almost all services in the scope of the tariff and limiting national prices to unbundled diagnostic imaging services.

On March 22, 2021, NHS England published the final version of the 2021/22 NHS Standard Contract and associated documents, which took effect from April 01, 2021. NHS England mandates the NHS Standard Contract for use by commissioners for all healthcare services contracts other than primary care. Changes mainly concerned introducing new "Aligned Payment and Incentive" (API) rules proposed by the 2021/22 National Tariff Payment System.

In March 2021, the National Institute for Health Research (NIHR) in England released six MedTech-related reports in its Health Technology Assessment (HTA) Journal, which concerned sacral nerve stimulation and magnetic sphincter augmentation device for fecal incontinence treatment, patch augmentation surgery for rotator cuff repair, in-vitro diagnostics, and eHealth. HTA Journal publishes research reports on the effectiveness, costs, and broader impact of health technologies for those who use, manage, and provide care in the NHS and inform National Institute for Health and Care Excellence (NICE) guidance.

On March 08, 2021, Academic Health Science Networks (ASHN) announced twelve innovators ("Fellows") and innovations selected to join NHS Innovation Accelerator (NIA) award-winning program in 2021. NIA is an NHS England and Improvement initiative delivered in partnership with England's 15 AHSNs, hosted at UCLPartners. All awarded technologies are related to eHealth, including digital platforms, mobile applications, artificial intelligence (AI), wearables for home-based diagnostic.

In March 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0175 and 0072 with changes to be implemented not later than May 01, 2021. Six new procedure codes related to gynecology, capsule endoscopy, and intracranial stereotactic radiotherapy were introduced. No changes were made in diagnostic test coding.

Starting April 2021, a significant change of the payment system for specialist care is expected in England. Most of the activity-based funding will be replaced by a blended payment model, including a fixed payment component and a variable component. All agreements will be made locally between commissioners and providers. This will be the next step towards abolishing activity-based (HRG-based) reimbursement according to the NHS Long-Term Plan.