Headline
The study found that the Health Technology Assessment programme has had impacts
on patients, health policy, clinical practice, the research system and industry,
and the economy; these impacts stem from the quality of the research, the focus
on UK NHS priorities, good governance, and close relationships with key policy
stakeholders.
Abstract
Background:
The National Institute for Health Research (NIHR) Health Technology
Assessment (HTA) programme supports research tailored to the needs of NHS
decision-makers, patients and clinicians. This study reviewed the impact of
the programme, from 2003 to 2013, on health, clinical practice, health
policy, the economy and academia. It also considered how HTA could maintain
and increase its impact.
Methods:
Interviews (n = 20): senior stakeholders
from academia, policy-making organisations and the HTA programme.
Bibliometric analysis: citation analysis of publications arising from HTA
programme-funded research. Researchfish survey: electronic survey of all HTA
grant holders. Payback case studies
(n = 12): in-depth case studies of HTA
programme-funded research.
Results:
We make the following observations about the impact, and routes to impact, of
the HTA programme: it has had an impact on patients, primarily through
changes in guidelines, but also directly (e.g. changing clinical practice);
it has had an impact on UK health policy, through providing high-quality
scientific evidence – its close relationships with the National
Institute for Health and Care Excellence (NICE) and the National Screening
Committee (NSC) contributed to the observed impact on health policy,
although in some instances other organisations may better facilitate impact;
HTA research is used outside the UK by other HTA organisations and
systematic reviewers – the programme has an impact on HTA practice
internationally as a leader in HTA research methods and the funding of HTA
research; the work of the programme is of high academic quality –
the Health Technology Assessment journal ensures that the
vast majority of HTA programme-funded research is published in full, while
the HTA programme still encourages publication in other peer-reviewed
journals; academics agree that the programme has played an important role in
building and retaining HTA research capacity in the UK; the HTA programme
has played a role in increasing the focus on effectiveness and
cost-effectiveness in medicine – it has also contributed to
increasingly positive attitudes towards HTA research both within the
research community and the NHS; and the HTA focuses resources on research
that is of value to patients and the UK NHS, which would not otherwise be
funded (e.g. where there is no commercial incentive to undertake research).
The programme should consider the following to maintain and increase its
impact: providing targeted support for dissemination, focusing resources
when important results are unlikely to be implemented by other stakeholders,
particularly when findings challenge vested interests; maintaining close
relationships with NICE and the NSC, but also considering other potential
users of HTA research; maintaining flexibility and good relationships with
researchers, giving particular consideration to the Technology Assessment
Report (TAR) programme and the potential for learning between TAR centres;
maintaining the academic quality of the work and the focus on NHS need;
considering funding research on the short-term costs of the implementation
of new health technologies; improving the monitoring and evaluation of
whether or not patient and public involvement influences research; improve
the transparency of the priority-setting process; and continuing to monitor
the impact and value of the programme to inform its future scientific and
administrative development.
Funding:
The NIHR HTA programme.
Article history
The research reported in this issue of the journal was funded by the HTA
programme as project number 14/06/07. The contractual start date was in May
2014. The draft report began editorial review in April 2015 and was accepted for
publication in July 2015. The authors have been wholly responsible for all data
collection, analysis and interpretation, and for writing up their work. The HTA
editors and publisher have tried to ensure the accuracy of the authors’
report and would like to thank the reviewers for their constructive comments on
the draft document. However, they do not accept liability for damages or losses
arising from material published in this report.
Declared competing interests of authors
none
