The MedTech Funding Mandate (MTFM)

What is the MedTech Funding Mandate?

The MedTech Funding Mandate (MTFM) is an NHS Long Term Plan commitment to give patients access to selected NICE approved, cost-efficient technologies more quickly.

To be considered for inclusion technologies needed to be:

• Effective: demonstrated through positive NICE guidance
• Cost-saving within three years of implementation: as demonstrated by NICE modelling and published in a NICE resource impact template
• Affordable to the NHS: the NICE budget impact analysis total costs should not exceed £20 million in any of the first three years

Which innovations are included in the MedTech Funding Mandate?

This mandate piloted four former Innovation and Technology Payment (ITP) products from 1^st April 2021. The chosen products are NICE approved and were selected as they met the criterion of being effective, cost-saving, affordable and capable of delivering material savings to the NHS and will continue to be supported in 2022/23.

The four products are:

• Placental Growth Factor (PLGF) – blood test to rule out pre-eclampsia in pregnant women.
• Heartflow – creates a 3D model of a patient’s coronary arteries and assesses the extent and location of blockages. Watch the latest Heartflow webinar
• gammaCore – a non-invasive vagus nerve stimulator used to alleviate the symptoms of cluster headaches and migraines.
• SecurAcath – a device for securing percutaneous catheters more securely.

A number of technologies have also been selected for inclusion in the 2022/23 policy which are categorised into two themes:

Benign prostatic hyperplasia (BPH)

This is a common condition in ageing men and others with a prostate (trans women, some non-binary and some intersex people). It is currently treated with the surgical procedure, transurethral resection of the prostate (TURP) which usually requires the patient to stay in hospital for 1 to 3 days. Four less invasive innovations allow patients with BPH to be treated as day cases. Providers will not be expected to implement all four technologies, instead, each would be expected to work with its AHSN and the Getting It Right First Time (GIRFT) Urology Area Networks to understand its technology needs and the potential uptake locally.The following four innovations allow patients with BPH to be treated as day cases. NHS providers will not be expected to implement all four technologies, instead, each is expected to work with Health Innovation East and the Getting It Right First Time (GIRFT) Urology Area Networks to understand its technology needs and the potential uptake locally.

• UroLift – The UroLift system lifts and holds the enlarged prostate tissue away from the urethra, relieving the compression of this organ. It can be performed under local anaesthesia in an outpatient setting or ambulatory care centre, and the patient can return home the same day without a catheter.
• GreenLight XPS – The GreenLight XPS vaporises prostatic tissue with a laser. The laser fibre is passed through a cystoscope to photoselectively vaporise the enlarged prostate tissue, leaving a clear urethral channel. GreenLight XPS can be done as a day case procedure, reduces the risk of complications, and allows a quicker return to normal activity.
• Rezum – Rezum is a minimally invasive procedure that uses water vapour (steam) to treat BPH. The technology delivers targeted, controlled doses of stored thermal energy in water vapour directly to the region of the prostate gland with the obstructive tissue causing lower urinary tract symptoms (LUTS). Rezum effectively alleviates BPH and patients can be treated as outpatients.
• PLASMA system – PLASMA is a bipolar electrosurgery system for transurethral resection and haemostasis of the prostate. The system uses electrodes to cut out (resect) prostate tissue and stop any local bleeding afterwards (haemostasis), which avoids the risk of transurethral resection syndrome and reduces the need for blood transfusion. This procedure can be done as a day case.

Improving patient experience

• XprESS multi-sinus dilation system – The XprESS multi-sinus dilation system is a sterile, single-use device for treating chronic sinusitis. Dilation of the XprESS balloon remodels the bony sinus outflow tract by displacing adjacent bone and paranasal sinus structures. This has the potential to reduce the tissue lost compared to traditional functional endoscopic sinus surgery (FESS) procedures.
• Thopaz+ portable digital system – Thopaz+ is a portable digital chest drain system that provides regulated negative pressure close to the patient’s chest and continuously monitors and records air leak and fluid drainage. The system comprises an inbuilt, regulated suction pump with a digital display, rechargeable battery, tubing that connects to any standard chest drain catheter and a Thopaz+ disposable fluid collection canister. Sensors in the system turn the pump on and off to ensure the pressure level set by the healthcare professional is precisely maintained.
• Spectra Optia – The Spectra Optia Apheresis System is an apheresis and cell collection platform for the treatment of sickle cell disease. In a typical exchange procedure, Spectra Optia separates and removes sickle red blood cells from the patient’s blood using continuous flow and centrifugation. These are replaced with healthy red blood cells according to the user-defined software protocol.

What is Health Innovation East doing to support this programme?

We are working with suppliers to support trusts to implement the selected innovations, understand local and regional issues and share learnings from NHS organisations who have already implemented these innovations. This will help us identify any barriers to their uptake, such as duplicative procurement processes.

NHS providers are expected to comply with the policy guidance and we will work closely with providers, clinicians, patient groups and commissioners to understand the impact of the policy and support its development.

This workstream includes:

• Raising awareness of the mandate and technologies with local NHS commissioners and providers
• Sharing local and national evidence to support innovations and work with NHS providers to enable peer to peer learning, sharing good practices, building business cases and understanding any barriers to adoption
• Gathering data to understand current and future levels of uptake of each technology across the region.
• Working with NHS commissioners to ensure processes and mechanisms are in place to support the implementation of these technologies
• Developing a comprehensive stakeholder map to ensure equitable dissemination

How are these technologies funded?

Med Tech Funding Mandate products are not centrally funded. NHS-funded care providers and commissioners are expected to fund and develop local agreements and comply with the mandate.

You can read more in the NHS MedTech Funding Mandate policy 2023/24: Guidance for NHS commissioners and providers of NHS-funded care.