Introduction: The NHS is legally obliged to fund and resource medicines and treatments recommended by NICE’s technology appraisals. Technology appraisals are recommendations on the use of new and existing medicines and treatments within the NHS. These can be medicines, medical devices, diagnostic techniques, surgical procedures, or health promotion activities. When NICE recommends a treatment ‘as an option’, the NHS must make sure it is available within 3 months (unless otherwise specified) of its date of publication, in line with NICE’s recommendation. (NICE).1
Integrated Care Systems (ICS) are partnerships of health and care organisations that come together to plan and deliver joined up services and to improve the health of people who live and work in their area. One of their aims is to tackle inequalities in outcomes, experience and access.2
In order to drive equitable access to treatment for its population the ICS requires the data to illustrate uptake rates of technologies across its geography.
Aim: This work aims to provide Integrated Care Systems with uptake rates of some NICE approved technologies, in order that they can use this data to work towards removing barriers to inequitable uptake for their whole population. This data will support the system to adequately commission sufficient service to support equitable treatment access based on the eligible population.
Method: The number of eligible patients has been estimated at the ICS level for seven of the NICE TA scorecard groupings; DOAC primary, hepatitis C, migraine, primary hypercholesterolaemia, severe asthma, icosapentethyl, and long-term insomnia. The number of eligible people for each domain was estimated from resources such as NICE resource impact templates, national patient registries, UKHSA reports, and NHS Digital data releases. The two cancer groupings were not included as it was not possible to sufficiently differentiate between the indications. The populations used for each ICS and England are annual averages for the respective calendar years, sourced from ePACT2. The number of patients receiving the medication has been estimated using primary (ePACT2) and secondary (SCMD) care, and NICE TA data sources.3-5 Adjustments have been made to account for loading doses and medication combinations. The percentage of the eligible population receiving treatment was then calculated.
Results: The uptake of NICE TA medicines for the groupings analysed were higher in the NEY and NW region than the England average, with the exception of long-term insomnia treatment in NEY. Notably, treatment of severe asthma in the eligible population was 37.2% (NEY) and 42.7% (NW) compared to 30.1% England average. DOAC primary care uptake values are over 100% of the eligible population. This is attributed to the ongoing rapid case finding of atrial fibrillation, as part of the national medicines optimisation opportunities programme. Newly diagnosed AF patients receiving treatment will be included in the medicines dispensed dataset potentially months before the AF prevalence dataset is updated, skewing the data to report as an over-estimate.
Conclusion: The data presented provides the ICSs in the Northern region with data to demonstrate that they are meeting their statutory obligations in the provision of certain NICE approved technologies. It further contextualises the uptake of these technologies against the demographics of the population and hence the extent of the eligible population.
This methodology has been designed utilising the data from the NICE TA scorecards5, therefore at this stage it only covers a limited number of technologies. However, with further development it will be possible to provide uptake data for a wider variety of NICE approved technologies.