UK

In April 2023, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 189 and 085 with changes to be implemented no later than June 15, 2023. Eighteen new procedure codes (concerning cardiovascular, endocrine, endoscopy, gastrointestinal, interventional radiology, neuromodulation, peripheral vascular, robotic surgery, men's health, and general surgery fields) and eight new diagnostic codes were introduced.

In April 2023, NHS England published an updated version of the National Genomic Test Directory for 2023/2024, which lists tests commissioned by NHS England via Genomic Laboratory Hubs. Sixteen new codes (test-indication combinations) were introduced in the Test Directory for cancer, and 25 new codes in the Test Directory for rare and inherited diseases.

In March 2023, the National Institute for Health and Care Research (NIHR) in England released two MedTech-related reports in its Health Technology Assessment (HTA) Journal, which concerned total ankle replacement versus ankle arthrodesis in end-stage osteoarthritis, and techniques for managing an impacted fetal head during emergency cesarean section. 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 informs National Institute for Health and Care Excellence (NICE) guidance.

OPCS-4 is the clinical coding classification of interventions and procedures undertaken within the NHS in England. It is updated every three years, reflecting current clinical practice to be used for statistical purposes and reimbursement. On April 1, 2023, a new version (OPCS-4.10) came into force. A total of 236 new four-character codes were introduced in multiple areas, including cardiovascular, endoscopy, ENT, gastrointestinal, urology, neurology, gynecology, breast reconstruction, and others.

In March 2023, the National Institute for Health and Care Excellence (NICE) published two new Interventional Procedure Guidance (percutaneous transluminal renal sympathetic denervation for resistant hypertension, endoluminal gastroplication for gastro-oesophageal reflux disease), three new Health Technology Evaluations via piloted early value assessment approach (CaRi-Heart for predicting cardiac risk in suspected coronary artery disease, ProKnow cloud-based system for radiotherapy data storage, and Genedrive MT-RNR1 ID Kit for detecting a genetic variant), and two new MedTech Innovation Briefings (QBTest and BPMpathway). No new clinical guidelines were published.

In late March 2023, NHS England released the 2023/25 NHS Payment Scheme (NHSPS) to come into force on April 1, 2023. NHSPS has been set for two years, replacing the National Tariff Payment System (published annually). The NHSPS specifies payment conditions for NHS-funded secondary care.

In late March 2023, NHS England released an annual update of HRG4+ Local Payment Grouper for 2023/24, to come into effect on April 1, 2023. No new HRGs were added. The HRG design has been updated to accommodate the latest version of procedure coding classification (OPCS-4.10).

In February 2023, the Scottish Health Technology Group, SHTG, released three MedTech-related assessments: selective internal radiation therapies (SIRT) for treating primary hepatocellular carcinoma, Feeling Good app, store-and-forward teledermatology for triage of primary care referrals.

In January-February 2023, Health Technology Wales published sixteen Medtech-related Topic Exploration Reports (TER), including stereotactic radiosurgery, percutaneous implantation of pulmonary artery pressure sensors, ambulatory patch ECG devices, and others; however, Health Technology Wales will not proceed with full appraisals on these topics. No Guidance was released for Medtech in January-February 2023.

In March 2023, a new ‘AI and Digital Regulations Service’ for developers and adopters of artificial intelligence (AI) and digital technologies was launched in England. Four organizations provide this multi-agency advisory service: NICE, Care Quality Commission, Medicines and Healthcare products Regulatory Agency, and Health Research Authority. The website is currently in public beta and focused on information for developers.

In February 2023, the National Institute for Health and Care Excellence (NICE) published two new Interventional Procedure Guidance (transvenous obliteration for gastric varices, biodegradable spacer to reduce rectal toxicity during radiotherapy for prostate cancer), one new Health Technology Evaluation (guided self-help digital cognitive behavioural therapy), and two new Medtech Innovation Briefings (LIVERFASt, and Ambu aScope 4 RhinoLaryngo). Also, one new clinical guideline was published, and one was updated.

In February 2023, NHS England released the position statement on Transcatheter Aortic Valve Implantation (TAVI) and Surgical Aortic Valve Replacement (SAVR) for symptomatic, severe aortic stenosis in adults to support elective performance. Previously, NHS England was commissioning TAVI at high surgical risk. This new position statement sets criteria for intermediate and low-surgical risk patients who are eligible for TAVI.