Specialised commissioning: lessons from history and looking to the future

Specialised commissioning: lessons from history and looking to the future
Nuffield Trust 1 October 2020

• A “long read” by Nigel Edwards which “looks back at the historical problems of specialised commissioning, why finding solutions has often been difficult, and how policy-makers can this time avoid the mistakes of the past.”

Quality of Life in Long-term Cancer Survivors

Quality of Life in Long-term Cancer Survivors: Implications for Future Health Technology Assessments in Oncology
Office of Health Economics 3 July 2018

• This literature review examines whether there is evidence to support the assumption that the QoL of long-term cancer survivors (LTCS) can be similar to that of age-/sex-matched population samples. 
• Twenty papers were included in the review, representing 23 studies covering a range of different cancers, with the majority collecting data from over 100 LTCS.
• Notwithstanding the very limited evidence base and potential limitations, of the studies reporting comparisons with population norms, the majority provided evidence that the QoL of LTCS is similar to that of the general population. However, it is unclear how generalisable the results are, due to the different study settings.

Radiology Information Systems

Special Report: Radiology Information Systems
Digital Health June 2018

• This briefing addresses how radiology information systems could to support management of radiology workload by sharing the reporting workload across NHS trusts, and by using artificial intelligence to automate some of the work currently performed by clinicians.

Projections of hip arthroplasty in OECD countries up to 2050

Projections of hip arthroplasty in OECD countries up to 2050 [ PubMed]
Hip Int. 2018 Sep;28(5):498-506. doi: 10.1177/1120700018757940. Epub 2018 May 21.

• The utilisation of hip implants in OECD countries continues to grow by a compound annual growth rate of 1.2%, leading to an increase from 1.8 million per year in 2015 to 2.8 (2.6-2.9) in the year 2050. The mean utilisation rate (incidence) of hip implants will increase from 184 (143-312) to 275 (174-457) per 100.000 total population in the same time. 
• Some countries will face an exponential use of hip arthroplasty of additional 100% or more and thus challenges for their health care budgets. Revision burden will increase disproportionately. 

Abstract

Diagnosis of prostate cancer using AI

Smart software can diagnose prostate cancer as well as a pathologist
European Association of Urology Congress 2018, 16 March 2018

• Chinese scientists and clinicians have developed a learning artificial intelligence (AI) system which can diagnose and identify cancerous prostate samples as accurately as any pathologist. Results showed an accurate diagnosis in 99.38% of cases, which the researchers claim is as accurate as a human pathologist. In the longer term it could lead to automated or partially-automated prostate cancer diagnosis.

The Future of Surgery

Future of Surgery - an independent commission
Royal College of Surgeons

• The RCS has launched an independent commission to explore the future of surgery.
• The Commission aims to set out a compelling and credible vision of the future advances in medicine and technology, and how those developments will affect the delivery of surgical care.
• The Commission will consider how demographic changes and the burden of disease will affect the delivery of surgical care and explore and identify the innovations that will most likely affect surgical treatment.
• Deadline for submissions -18 February 2018.

Artificial Intelligence in the NHS

Thinking on its own: AI in the NHS
Reform 11 January 2018

• This report illustrates the areas where artificial intelligence (AI) could help the NHS become more efficient and deliver better outcomes for patients. It also highlights the main barriers to the implementation of this technology and suggests some potential solutions. 
• Main issues discussed in the paper include early adopters, potential of AI in the NHS, improving buy-in, getting data right and the ethics of building AI.

AI early diagnosis could save heart and cancer patients

AI early diagnosis could save heart and cancer patients
BBC News 2 January 2018

• Researchers at John Radcliffe Hospital, Oxford have developed an artificial intelligence (AI) system that can diagnose scans for heart disease and lung cancer. The systems will save billions of pounds by enabling the diseases to be picked up much earlier. The heart disease technology will start to be available to NHS hospitals for free this summer.

Specialised Services Commissioning Committee report 30 November 2017

Specialised Services Commissioning Committee (SSCC) Report
NHS England Board Meeting 30 November 2017

• Extract from minutes:
• "Horizon scanning for new technologies - The Committee received an outline of the current tools used to understand the pharmaceutical pipeline, and the estimate of likely financial impact on specialised commissioning.”
• The following points were made in discussion: 
• The Committee recognised the progress that had been made and discussed how the approach might be augmented to provide greater quantification of future pipeline. 
• The issue of how to create a similar approach for medical technology devices and diagnostics was raised. It was agreed that a paper on this would be brought back to a future discussion. 
• The Committee discussed the need to be able to compare the effectiveness of multiple drugs for the same indication. It was agreed that NHS England would explore the possibility of this approach with NIHR and NICE.
• It was concluded that further work would need to be conducted to model longer horizon periods (eg 2-3 years) to see the longer-term financial impact of the pharmaceutical pipeline."