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NSW Framework for New Health Technologies and Specialised Services

Summary This document is a guide for districts, networks and pillars to support their role in locally evaluating new health technologies. The guideline outlines the process for reviewing and assessing health technologies that are new to the NSW public health system. It informs how local processes intersects with those of the NSW Ministry of Health. It also provides advice on how purchasing decisions are made for specialty services in NSW Health.

Document type Guideline

Document number GL2018_023

Publication date 12 November 2018

Author branch Health System Planning & Investment

Branch contact (02) 9391 9182

Replaces GL2017_020

Review date 12 November 2023

Policy manual Not applicable

File number H18/78839

Status Active

Functional group Clinical/Patient Services - Governance and Service Delivery

Applies to Ministry of Health, Local Health Districts, Board Governed Statutory Health Corporations, Specialty Network Governed Statutory Health Corporations, NSW Health Pathology, Cancer Institute, NSW Ambulance Service

Distributed to Ministry of Health, Public Health System, NSW Ambulance Service

Audience All Clinical Staff and Executives

Guideline

Secretary, NSW Health

GUIDELINE SUMMARY

GL2018_023 Issue date: November-2018 Page 1 of 1

NSW FRAMEWORK FOR NEW HEALTH TECHNOLOGIES AND SPECIALISED SERVICES

PURPOSE This Guideline outlines the process for review and assessment of health technologies that are new to the NSW public health system. The document guides districts, networks and pillars in the local evaluation of new health technologies and provides information on when local processes intersect with those of the NSW Ministry of Health. It also outlines the Ministry’s processes for purchase of specialty services.

KEY PRINCIPLES Decisions made about the introduction of new health technologies in NSW should be balanced by the available evidence, cost implications and the requirement of the health system to provide contemporary high quality clinical services. NSW Health supports innovation at the local level and Districts / Networks may choose to implement new health technologies or provide services locally that are not adopted for use at a statewide level. During this process, a District / Network may nominate technology to the NSW Ministry of Health for statewide or national review. The NSW Ministry of Health will follow a prioritisation matrix to analyse and make decisions for the introduction of new health technology for statewide implementation.

USE OF THE GUIDELINE The Chief Executives of NSW Districts / Networks and Pillar Organisations are responsible for the implementation of this Guideline within their services / facilities. This includes ensuring that local protocols or operating procedures are in place, are aligned and are consistent with this Guideline. All staff should be aware of the Guideline and actively participate in its implementation.

REVISION HISTORY Version Approved by Amendment notes December 2016 (GL2017_001)

Deputy Secretary, Strategy and Resources

New Guideline

January 2017 (GL2017_020)


Revised Guideline

November 2018 (GL2018_023)


Revised Guideline

ATTACHMENTS 1. NSW Framework for New Health Technologies and Specialised Services: Guideline


GUIDELINE

Issue date: November 2018

GL2018_023


GUIDELINE

GL2018_023 Issue date: November-2018 Contents Page

CONTENTS 1. BACKGROUND ................................................................................................................................... 1

1.1 What do we mean by ‘Health Technology’ ..................................................................................... 1 1.2 About this Document ...................................................................................................................... 1 1.3 Role of the Ministry in Planning ...................................................................................................... 2 1.4 Planning for Specialised Services in NSW ..................................................................................... 3

2. INTRODUCTION OF NEW HEALTH TECHNOLOGIES: LOCAL PROCESS ..................................................... 4

2.1 Identify and Investigate ................................................................................................................... 4 2.2 Assess ............................................................................................................................................. 6 2.3 Service Planning ............................................................................................................................. 6

2.3.1 Risk Assessment and Management ............................................................................................................ 7

2.4 Implement ....................................................................................................................................... 7 2.5 Monitor and Evaluate ...................................................................................................................... 7 2.6 Case Study 1: Local Implementation of a Health Technology ...................................................... 8

3. INTRODUCTION OF NEW HEALTH TECHNOLOGIES: STATEWIDE ASSESSMENT AND IMPLEMENTATIONPROCESS ............................................................................................................................................ 9

3.1 Emerging Technology Update ........................................................................................................ 9 3.1.1 New Technology Nomination ..................................................................................................................... 9

3.1.2 Dissemination of New Technology Updates and Nominations ............................................................... 10

3.2 The NSW Health Technology and Specialised Services Committee .......................................... 10

4. INTRODUCTION OF NEW HEALTH TECHNOLOGIES: NEW TECHNOLOGY NOMINATIONS ...................... 12

4.1 Nominating a New Technology ..................................................................................................... 12 4.2 Assessment of Nominations ......................................................................................................... 13

5. IMPLEMENTATION OF NEW HEALTH TECHNOLOGIES: PURCHASING AND MONITORING OFTECHNOLOGIES AND SPECIALISED SERVICES ..................................................................................... 15

5.1 Approval Process – Recommended Technologies ...................................................................... 15 5.2 Purchasing of New Technologies and Specialised Services for Statewide Provision ................ 15

5.2.1 Ongoing Purchasing of Established Supra LHD Services .......................................................................... 16 5.2.2 Transitioning from Supra LHD Status to a Networked Service ................................................................ 16

5.3 Monitoring and Evaluation Framework ......................................................................................... 17 5.4 Case study 2: Introduction of New Health Technologies – State Level ...................................... 18

6. IMPLEMENTATION OF NEW HEALTH TECHNOLOGIES: LINKS TO NATIONAL HEALTH TECHNOLOGYPROCESSES ...................................................................................................................................... 19

6.1 Health Technology Expert Reference Group ............................................................................... 19 6.2 Nationally Funded Centres (NFC) Program ................................................................................. 19 6.3 Case Study 3: Purchasing and Monitoring of Specialised Services ........................................... 20 6.4 Case Study 4: Supporting on-going Purchasing Decisions in Service Agreements .................. 21

APPENDIXES ........................................................................................................................................... 22

1. NSW Health: New Technology Nomination Form ........................................................................ 232. NSW Health Technology and Specialised Services Strategic Forum: Prioritisation & Assessment

Matrix............................................................................................................................................. 30 3. NSW Health Emerging Technology Update Form ....................................................................... 314. Annual Update & Nomination Schedule ....................................................................................... 34


GUIDELINE


1. BACKGROUND

1.1 What do we mean by ‘Health Technology’ A health technology is an intervention that may be used to promote health, to prevent, diagnose or treat acute or chronic illness, or for rehabilitation1. It may take the form of a medical device, procedure or process of clinical management which is substantially different from the alternative, and has the potential to impact the experience of giving and receiving care, improve outcomes and enhance efficiency and effectiveness.

Health technologies play an important role in achieving the key goals set out for the NSW Health system in NSW State Health Plan: Towards 2021; to keep people healthy and out of hospital, to provide world-class clinical services and to deliver truly integrated care.

Decisions made regarding the introduction of new health technologies in NSW should be balanced by the available evidence, cost implications and the requirement of the health system to provide contemporary high quality clinical services. Local and statewide implementation of new health technologies requires different levels of supporting evidence, and funding models. Innovations in health care should move from bench to bed-side and on to statewide adoption as the evidence supporting their use matures.

1.2 About this Document NSW Health supports innovation at the local level and Local Health Districts (districts)/ Specialty Health Networks (networks) may choose to implement new health technologies or provide services locally that are not adopted for use at a statewide level. In these instances these services are provided with district/network resources.

Section 2: outlines processes for districts/networks to consider whenintroducing of a new health technology for local implementation.

Section 3: provides advice and tools to help districts and networks totransition a technology from local application to statewide adoption. Theimplementation of new health technologies usually occurs within the context ofchange in service provision, models of care, clinical education and trainingand/or the establishment of a new service.

The principles of technology assessment and implementation presented in this framework are applicable for all technologies and should be used when considering whether to introduce any new technology to local patient care pathways. The Ministry considers a subset of health technologies for statewide adoption. Technologies listed as out of scope for Ministry consideration (Section 4.1) are ones that fall under the responsibility of other agencies or organisations.

The NSW Ministry of Health adheres to a defined process for the analysis, prioritisation, and purchasing of new health technologies. An illustration of these processes and their intersection points is at Figure 1.

1 HTA Glossary.net. Available from: http://htaglossary.net/health+technology. [Accessed June 2016].

http://www.health.nsw.gov.au/statehealthplan/Pages/NSW-state-health-plan-towards-2021.aspx

http://htaglossary.net/health+technology


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Figure 1: Local and statewide processes for introduction of a new health technology

1.3 Role of the Ministry in Planning In NSW the districts and networks are responsible for planning services that are responsive to the needs of their local population2. The Ministry is responsible for co-ordinating the planning of services to meet the needs of the NSW population. The Ministry also has a role in informing national health initiatives and coordinating the NSW system response to these initiatives2.

The Ministry’s role in planning lies along a continuum from setting broad directions in healthcare provision to leading specific planning processes such as the planning and oversight of specialised services2.

2 Corporate Governance Planning and Accountability compendium: http://www.health.nsw.gov.au/policies/manuals/pages/corporate-governance-compendium.aspx.

http://www.health.nsw.gov.au/policies/manuals/pages/corporate-governance-compendium.aspx


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1.4 Planning for Specialised Services in NSW Planning future capacity for NSW Health services is underpinned by robust clinical service planning that considers service demand over the next 10 – 15 years and factors including:

Target population projections Age, sex, morbidity of patient groups Changing trends in patterns of disease and treatment

Statewide priorities Affordability and cost-benefit Development of new models of care

Quality and safety considerations Availability of skilled workforce.

NSW Health has a range of planning tools, guidelines and methodologies to estimate future demand and support the planning of health services. This includes the Clinical Services Planning Analytics (CaSPA) which is available to NSW health planners.

The impact of a new technology or clinical service on the health system will determine the most appropriate approach to service planning and provision (Figure 2). This ranges from a district/network managed service for their local population up to the Nationally Funded Centres (NFCs) Program for highly complex, small volume services that require a national population for safe and effective service provision.

The new health technologies framework represents a coordinated approach to the assessment of technologies to support a transparent process for the planning and purchase of new health technology in NSW.

Figure 2: Approach to specialised service planning in NSW

Nationally Funded Centres Program (NFC) - highly specialised services for small

populations requiring a national approach to planning

Supra-LHD services - planning by NSW Minstry of Health as highly specialised services offered by limited sites on behalf of NSW

Networked service - planning by district/network but may support

other services within a defined clinical network e.g. hub and spoke models of care

Local service provision - planning by district/network to meet the needs

of the local population

National Planning

Ministry Planning

Local and inter-district/network Planning

Local Planning


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2. INTRODUCTION OF NEW HEALTH TECHNOLOGIES: LOCALPROCESSThis section outlines the suggested process for district/network introduction of a newtechnology and refers to local implementation only. An example case study of a localimplementation process is included in Item 5.6 of this Section.

The Ministry suggests that districts/networks develop local processes to identify, assess,fund and evaluate new health technologies to ensure a robust approach to innovation.

The Ministry proposes a five step process to effectively progress new health technologies ina framework that does not compromise patient safety or quality of care:

1. Identify and Investigate2. Assess3. Service Planning4. Implement5. Monitor and Evaluate.

2.1 Identify and Investigate A new health technology may be identified by local clinicians for implementation within their district/network. This can occur through a number of channels, including:

Formal state and national processes i.e. Health Technologies Reference Group

Licensing and reimbursement agencies i.e. Therapeutic Goods Administration (TGA)

Published literature and conference proceedings Experts and expert groups, including professional associations Technology manufacturers.

Once a technology has been identified, it is recommended that a formal proposal is developed to enable a robust assessment and evaluation. This should include the justification for the introduction of the new technology. Proposals should address the points outlined in Table 1.

To assist with this process the district/network may wish to refer to the NSW Ministry of Health’s New Health Technology Nomination form at Appendix 1. The form is used by the Ministry to guide the submission of annual nominations of new technologies for statewide

implementation through its new health technology evaluation process and can be adapted by district/networks for local use.


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Table 1: Local New Health Technology proposals, suggested inclusions

New Health Technology Proposal Resources

Justification and Rationale

A rationale for the introduction of the technology at a local level, including local clinical need, benefits compared to current treatment approaches and evidence to support the proposed change.

Clinical Evidence

Quality, value and impact ofscientific evidence.

Potential impact on patient andprovider experience.

Anticipated outcomes including,length of stay, readmission ratequality of life impacts and morbidityand mortality rates.

Acceptability of the technology.

It is recommended that a hierarchy of evidence be applied. Established guidelines may be useful, such as:

TGA Evidence Guidelines

National Health and MedicalResearch Council (NHMRC)Levels of evidence and gradesfor recommendation fordevelopers of guidelines (2009)

Impact on efficiency and effectiveness

Potential impact of the newtechnology on efficiency andeffectiveness.

Cost-benefit analysis includingoperating costs, capital andequipment requirements, workforcerequirements and any offsets orsaving compared to current practice.

Opportunities for servicereconfiguration with theintroduction of the new healthtechnology, including potentialsavings or enhancements in servicedelivery through changes to practiceor model of care.

Disinvestment opportunities.

Understanding the use ofhealth economics models: AnACI Framework

Service Proposal

Information on how the technology will be introduced, including proposed target population, selection criteria and anticipated volume

Mapping of the proposed patientpathway and care model.

Expected impact on other clinicaland supportive services.

Safety requirements relating to thetechnology’s introduction, includingtraining and credentialingrequirements, infection preventionand control.

Identification and review of anyconflicts of interest and areas ofpotential bias

e.g. manufactures/supplier.

Monitoring and Evaluation Planned approach to monitoring andevaluation.

The NSW GovernmentEvaluation Guidelines

https://www.tga.gov.au/publication/evidence-guidelines

http://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0007/181933/HS13-032_framework_Health_Economics_D8.pdf



https://arp.nsw.gov.au/sites/default/files/NSW%20Government%20Program%20Evaluation%20Guideline%20January%202016_1.pdf

https://arp.nsw.gov.au/sites/default/files/NSW%20Government%20Program%20Evaluation%20Guideline%20January%202016_1.pdf


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2.2 Assess It is recommended that each district/network have a locally-established process, with clearly defined governance, for the review, assessment, approval and oversight of the implementation of new health technologies. This may be a specialised committee established for the sole purpose of new health technology assessment/evaluation, or an additional function of an established committee such as the Local Clinical Governance Committee.

The Committee may need to prioritise technologies for local review or adoption. The district/network may wish to refer to the Ministry’s Prioritisation and Assessment Matrix (Appendix 2) to assist with this process. The matrix is used by the Ministry to prioritise nominated technologies and may be adapted for local use.

Once the Committee has agreed to proceed with the introduction of a new technology, it is recommended that final sign off be sought through the district/network’s Chief Executive or their delegate.

2.3 Service Planning The local Committee overseeing the introduction of a new health technology should ensure responsibility and accountability for the planning and implementation is assigned to a specific team. This team would be responsible for risk assessment and management. The implementation team should regularly report progress of the introduction of the new technology across the district/network to an executive sponsor.

The implementation team should consider: Whether the role delineation of the service aligns to the requirements of the

new health technology.

The impact that introduction of the new health technology may have on theconfiguration of local service delivery and model of care.

Funding allocation/reallocation strategies, including the identification offinances, disinvestment and savings opportunities.

Access to adequate education and training for staff and/or identifying staff thatare appropriately trained to use the new health technology.

Technology and infrastructure requirements, ensuring there are strategies forreviewing and facilitating any necessary changes or introduction of newfixtures and/or equipment.

Development of clinical pathways and/or protocols which may include consentprocedures, clinical protocols, patient referral requirements, approaches totransfer of care and follow-up and communication pathways with referrersincluding Primary Health Networks (PHNs).

Development of appropriate consumer literature and information.

When establishing a new service, or introducing a new technology into anexisting service, districts/networks are encouraged to consider opportunitiesfor future publication of outcomes. Early applications to local ethicscommittees will enable clinicians to effectively contribute to the national andinternational evidence base.


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2.3.1 Risk Assessment and Management The risk assessment and management process is integral when considering implementation of a new technology, procedure or service and should be:

Tailored to the specific activity and environment Transparent and inclusive Responsive to change Actively promoting continuous improvement Considerate of ethical, human and cultural factors, in line with statewide and

local ethical processes as outlined in the Human Research Ethics Committees

– Quality Improvement & Ethical Review: A Practice Guide for NSW

(GL2007_20).

To assist with this process, districts/networks can refer to the risk management process described in AS/NZS ISO 31000:2009 Risk Management – Principals and Guidelines. These guidelines introduce the 11 principles of risk management and a generic framework for assessing, treating and prioritising risks and opportunities. Any risk assessment conducted should be in line with the framework Risk Management – Enterprise-Wide Risk Management

Policy and Framework – NSW Health (PD2015_043).

2.4 Implement An implementation plan should be developed to guide the work of the implementation team. All stakeholders, including clinicians and managers, may inform the work of the implementation team to ensure that the safety and effectiveness of the technology is maximised. Any new risks that are identified during the implementation phase can be addressed through mitigation strategies developed by the implementation team.

2.5 Monitor and Evaluate Program monitoring and evaluation should be undertaken to measure the impact of the new technology across the domains of experience (of giving and receiving care), outcomes and, effectiveness and efficiency. The NSW Government Program Evaluation Guidelines should be used to guide this process. Integration of a monitoring and evaluation plan will allow continuous assessment of the impact of the new health technology and optimisation of service delivery as required.

Formative evaluation may identify opportunities for optimisation in the use of the new health technology. Opportunities for optimisation could include additional education and training of staff as well as assessment and review of the clinical scope of the technology over time as the evidence and expertise regarding the use of the new health technology develops. Changes to practice should be endorsed by the local committee that originally assessed and approved the new technology prior to any changes being applied.

New health technologies should be subject to pre-specified stopping criteria agreed at the time of approval by the local assessment committee. The development of trigger incidents specifically related to the new health technology may be of use as a part of this process. The director of clinical governance should be notified immediately if the stopping criteria are met. The decision to recommence the new health technology may be based on the outcome of the incident/adverse event review investigation and with the approval of the chief executive.

https://www1.health.nsw.gov.au/PDS/pages/doc.aspx?dn=GL2007_020

https://www1.health.nsw.gov.au/PDS/pages/doc.aspx?dn=GL2007_020

http://www.finance.gov.au/sites/default/files/COV_216905_Risk_Management_Fact_Sheet_FA3_23082010_0.pdf

https://www1.health.nsw.gov.au/PDS/pages/doc.aspx?dn=PD2015_043

https://www1.health.nsw.gov.au/PDS/pages/doc.aspx?dn=PD2015_043

http://www.dpc.nsw.gov.au/programs_and_services/policy_makers_toolkit/evaluation_in_the_nsw_government


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2.6 Case Study 1: Local Implementation of a Health Technology

Robot-Assisted Surgery

The use of robotics in surgery has become increasingly popular in colorectal, cardiothoracic, gynaecology, orthopaedics, paediatrics, urology and vascular surgery. This case study illustrates how a new robotic technology was identified, assessed and introduced via an LHD’s local new health technology process.

Step 1: Identify and Investigate

LHD clinicians first identified an interest in robotic technology in 2006. Further evidence emerged supporting the use of robot-assisted surgery and the LHD nominated the technology for consideration by their new health technology committee.

Step 2: Assess

In late 2015, the decision was made to purchase a da Vinci Xi surgical robot for clinical use under the banner of the LHD’s surgical robotics program. The Program was established in collaboration with a University to contribute to the growing evidence-base regarding the strengths, limitations, costs and benefits of robotic surgery for a range of indications. The Committee recommended that the use of the new surgical robot be restricted to clinicians participating in research and collecting data to support the evidence base.

Step 3: Service Planning

An operational/implementation plan was developed to ensure all aspects of the robotic research program aligned. The plan included consideration of clinical pathways and business rules, pre-operative care, management of consumables and arrangements for sterilisation, data monitoring, continuous quality audits, requirements for education and training and the writing of a communication strategy.

An education and training pathway was developed to ensure that the surgical teams had appropriate skills and experience to use the robot safely and efficiently. This involved a pathway of training, credentialing and ongoing education.

Step 4: Implement

The program was established under a governance structure and oversight is provided by the LHD’s dedicated Surgical Robotic Program Steering Committee. This Committee is responsible for the governance of working groups in research, education and training, and operational issues.

Step 5: Monitor and Evaluate

An established research pathway has guided the development of an overarching evaluation framework to complement specific research projects investigating safety, effectiveness and cost-effectiveness. This pathway includes the development of appropriate processes to support ethics applications.


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3. INTRODUCTION OF NEW HEALTH TECHNOLOGIES: STATEWIDEASSESSMENT AND IMPLEMENTATION PROCESSThere are significant differences in the level of evidence required to implement a new healthtechnology at a local level, compared to a system level implementation and adoption acrossmultiple sites. The Ministry has a formal process for notification, assessment, prioritisationand purchasing of new technologies which is described in the following sections.

There are two main pathways for districts/networks to engage with the Ministry’s assessmentand implementation processes. This is done as either an emerging technology update or anew technology nomination. Both pathways are reviewed by the New Health Technologyand Specialised Services Committee (The Committee, Section 3.2). This section providesmore information on the process for each pathway.

3.1 Emerging Technology Update Districts and Networks are encouraged to submit an emerging technology update during the local identification and investigation phase when a technology:

Is new to NSW

Is the subject of emerging or translational research

Requires a health technology assessment

Has been trialled locally but was not found to have benefits over the existingstandards of care.

The Ministry will invite the submission of emerging technology updates annually in June for review by the Committee at their August meeting.

Emerging technology updates support the Ministry in maintaining current knowledge of technologies under evaluation or being considered for local implementation across NSW. This is particularly important for long-term service planning and purchasing decision making.

3.1.1 New Technology Nomination A new technology nomination can be made by district/networks if they consider there is potential for local technologies to be formally assessed for statewide/national review and/or implementation. A district/network may wish to nominate a new technology if:

Local assessment has demonstrated safety, efficacy and cost-effectivenessover existing standards of care

The statewide population is needed for service delivery i.e. the service would be provided across district/network catchments

The technology is highly specialised/low-volume

Specialist workforce is required

Significant financial investment is required to establish the service.


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The Ministry will invite the submission of nominations annually following the August meeting of the Committee. The process of nomination, review and approval is discussed in detail in Section 4.

All updates and nominations should be approved by the Chief Executive of district/network or pillar agency. Please note updates and nominations will not be accepted from individual Hospitals or Clinicians.

3.1.2 Dissemination of New Technology Updates and Nominations The Ministry would like to share a summary of emerging technology updates and new technology nominations on the New Health Technologies webpages which are housed on the NSW Health Intranet. The purpose of this is to increase knowledge and facilitate collaboration in the system.

Following the assessment process, the Ministry will draft a summary of the technology. The summary will not be shared without approval from the nominating district/network chief executive.

Final sign off for any web content will sit with the Deputy Secretary, Strategy and Resources.

3.2 The NSW Health Technology and Specialised Services Committee In NSW a coordinated approach to the assessment of health technologies underpins the introduction of technologies that are new to the NSW public hospital system.

The Committee is an expert advisory group established to facilitate planning and prioritisation of specialised services in the system.

The Committee provides strategic oversight of the Ministry’s new health technology and specialised services process, including:

Prioritising nominations of new health technologies to determine those forfurther consideration or assessment

Advising on emerging health technologies that may impact NSW

Advising on opportunities for disinvestment

Making recommendations to the Secretary regarding the purchasing ofsupra LHD or specialised services

Making recommendations to the Secretary regarding services that requiretransitioning from a supra LHD to a networked service.


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The membership of the Committee includes:

NSW Ministry of Health Deputy Secretary, Strategy and Resources (Chair)

NSW Chief Health Officer

Deputy Secretary, System Purchasing andPerformance

Executive Director, Health System Planning andInvestment

Director, Office of Health and Medical Research

Director, Specialty Service and TechnologyEvaluation

NSW Agency for Clinical Innovation Chief Executive

Cancer Institute NSW Chief Executive

Clinical Excellence Commission Director, Clinical Governance

Advice will be sought from NSW Health Pathology and eHealth NSW and subject matter experts as required.

The work of the Committee is coordinated by the Ministry. Where necessary, the Ministry may engage expertise in core areas such as health technology review and assessment, bioethics, epidemiology, health economics, and clinical and medical research expertise.

Any further technology assessment identified as necessary by Committee members will also be progressed by the Ministry and may consider demand analysis, cost effectiveness or workforce requirements. Where identified, the nominated technology may also be referred to the national Health Technology Reference Group (HTRG, formerly HealthPACT) for review and/or advice (Section 6.1).


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4. INTRODUCTION OF NEW HEALTH TECHNOLOGIES: NEWTECHNOLOGY NOMINATIONSThis section will outline the process for prioritisation, analysis and decision making for thestatewide consideration and introduction of new health technologies. An example case studyof how this guidance can be applied is included Section 5.4.

4.1 Nominating a New Technology Health technologies that are new to the NSW public health system and meet the following criteria may be nominated to the Ministry by the district/network or pillar for full review and assessment in the following circumstances:

Technology may have significant positive system impacts if adopted acrossNSW

Volume/quality outcome relationship for the technology supports a case forservice concentration i.e. a statewide population is needed for safe, effective and efficient

service delivery

Technology is highly specialised and likely to be low volume i.e. will only be provided in a limited number of locations

Limited/highly specialised workforce is required Significant infrastructure is required There are other factors that elevate the new health technology out of local

planning/budgeting capacity, such as specific specialised technicalrequirements or significant financial investment

Technology represents a significant opportunity to reduce and/or replaceexisting redundant technologies, as well as the potential offsets of the newtechnology within the same model of care e.g. reduced length of stay.

Additionally, technologies may be identified to the Ministry through a number of other channels, including:

Advice from the Committee National and jurisdictional health technology processes

e.g. HTRG

Clinical networks and work program of pillars Regular performance meetings between the Ministry and districts/networks Local health technology evaluation processes.

Technologies may be identified for assessment of statewide application if they are transitioning from the research phase into clinical practice or are established technologies that are new to the NSW public health system. Technologies still in the early stages of development should be investigated via an ethics-approved research study and are therefore not appropriate for consideration by the Committee.


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In-scope technologies for Ministry level consideration are:

Implantable devices Medical and surgical procedures Treatment and diagnostic technologies

Technologies nominated for disinvestment Genetic markers, gene-based diagnostics or gene therapies The use of existing technologies for applications not adequately supported by

clinical evidence e.g. new or emerging indications.

Out-of-scope technologies are considered to be: Medicines3

including radiopharmaceuticals Information and communication technologies (ICT) Public health activities and programs Primary health technologies

Technologies not approved by the Therapeutic Goods Administration (TGA)4.

The annual round of expression of interest nominations open in September and close in November each year (Appendix 4).

4.2 Assessment of Nominations During the assessment process the Committee can:

Seek further information or assessment of the technology Refer to the Nationally Funded Centres (NFC) Program for very low volume,

high cost and highly specialised services

Recommend a service is purchased as a supra LHD or networked service tothe Secretary, NSW Ministry of Health.

The Committee’s review process considers available evidence to inform advice, including but not limited to:

Leveraging relevant national and jurisdictional processes in healthtechnology review and assessment (Section 6.1) e.g. HTRG

Consideration of previous health technology assessments, clinical andfunding information and reviews

Advice from the relevant NSW Health pillar(s).

3 Medicines are excluded due to existing processes in place within NSW. A process for off-label use of unapproved drugs (including radiopharmaceuticals) is set out in Approval Process of Medicines for Use in NSW Public Hospitals (PD2016_033). Hybrid technologies such as drug eluting stents are considered by the committee.

4 As a general principle, the routine use of non-TGA approved products outside of a dedicated clinical trial is not supported in NSW public health facilities. However, it is acknowledged that there are some technologies that will not have or require TGA approval (e.g. islet cell transplantation) or may not be amendable to clinical trials. In such cases, there may be a need to consider such technologies through the New Technologies Committee. This may include those that are being routinely used under the Special Access Scheme and Importation for Personal Use or Authorised Prescriber schemes.

https://www1.health.nsw.gov.au/pds/Pages/doc.aspx?dn=PD2016_033

https://www1.health.nsw.gov.au/pds/Pages/doc.aspx?dn=PD2016_033


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Devices that have been awarded funding or supported through the Medical Device Fund can be submitted for consideration by the Committee. They will be subject to the same approval and prioritisation processes.

A matrix is used by the Ministry and the Committee to assess applications against agreed criteria (Appendix 2). The Committee may decide to engage in further assessment via health technology review or consultation with subject matter experts. Following full assessment, applications will be provided with one of five outcomes (Table 2).

In the event that a district/network has nominated a new technology that is later considered for statewide purchasing, they may be required to enter into a competitive expression of interest process to be considered as the service provider.

Table 2: Statewide health technology evaluation outcomes

Outcome Definition Action

Out of Scope The technology is out-of-scope (Section 4.1) or the nomination is for local district/network use only

Not Recommended Health technology has not demonstrated benefit in terms of experience, outcomes or effectiveness and efficiency compared to standard treatment

Archive technology

Still in Research Not enough clinical evidence is available to assess experience, outcomes or effectiveness and efficiency compared to standard treatment

District/network may use the technology under a research/evaluation framework.

May consider a further application when more evidence is available.

Seek Further Advice

Technology has been found to have some benefits in certain population groups, but more information is required to form a recommendation

Further advice and/or technology assessment sought

Recommended Health technology has proven benefit in terms of experience, outcomes and effectiveness and efficiency compared to standard treatment. NSW population would benefit from provision of service.

Negotiation on service delivery and purchasing options may include expression of interest processes or nomination to the NFC program.


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5. IMPLEMENTATION OF NEW HEALTH TECHNOLOGIES:PURCHASING AND MONITORING OF TECHNOLOGIES ANDSPECIALISED SERVICESOnce a technology has been recommended for statewide purchasing by the Committee thereis an established process to review and negotiate purchasing options. A case studydemonstrating this process is included in Item 5.4 of this Section.

5.1 Approval Process – Recommended Technologies Recommendations for statewide implementation made by the Committee require approval from the Secretary, NSW Health, before proceeding with purchasing negotiations.

The Secretary is provided with supporting evidence to assist with the approval process. This includes: clinical need, effectiveness, feasibility, and ethical and equity considerations.

If implementation is approved by the Secretary, the Ministry will lead a process to determine the purchasing approach for that technology. The following sections provide an outline of this process.

5.2 Purchasing of New Technologies and Specialised Services for Statewide Provision All new technologies recommended for statewide implementation are considered in the annual service agreement cycle managed by the Ministry’s System Purchasing and Performance Division. All purchasing decisions are made in the context of the overall NSW Health budget. Purchasing decisions will focus on system issues such as number of sites required, geographic location, infrastructure and equipment requirements, workforce considerations, and evidence-based patient selection criteria.

The Ministry will advise the parameters for introducing the new health technology, such as volume, agreed indications. The district/network tasked with providing the service will be responsible for further implementation and planning, including clinical requirements, service delivery, staffing, monitoring and evaluation.

It should be noted that where a district/network has nominated a new technology that is later considered for statewide purchasing consideration, they may be required to enter into a competitive expression of interest process to determine the service provider.

Purchasing models for new technologies in NSW fall into two broad categories:

1. Supra LHD service: Supra LHD services are provided across district/networkboundaries and are characterised by a combination of the following factors: Services are provided on behalf of the State that is, a significant

proportion of service users are from outside the hostdistrict/network catchment

Services are provided from limited sites across NSW Services are high cost with low-volume activity Individual clinicians or teams in supra LHD services have

specialised skills Provision of the service is dependent on highly specialised

equipment and/or support services


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Significant investment in infrastructure is required.

Supra LHD Services are assigned a Clinical Lead (e.g. Cancer Institute NSW) who is responsible for identifying issues such as changes to clinical evidence and model of care that may influence current and/or future demand.

2. New service: time-limited funding and/or managed diffusion prior towidespread use. Technologies/services for limited introduction may betransitioned into a new Supra LHD Service following initial introduction, orwhere a national population base is required, the service may be consideredfor submission through the Nationally Funded Centres (NFC) process(Section 6.1).

5.2.1 Ongoing Purchasing of Established Supra LHD Services Health Service Planning and Investment branch, in consultation with the relevant clinical lead, will provide advice to System Purchasing and Performance Division to inform the purchasing decisions for supra LHD Services during the annual service agreement negotiations with the host district/network. This process will be adapted for each supra LHD service in discussion with the relevant clinical lead. An example of this approach can be found at Case study 4.

5.2.2 Transitioning from Supra LHD Status to a Networked Service The data obtained for the monitoring and evaluation (Section 5.3) will be used to determine whether supra LHD services continue to meet the criteria outlined above. If the service becomes more diffuse in the system it may be considered for transition to a networked service. Networked services are those provided under networked clinical arrangements and are provided at a greater number of sites than supra LHD services.

The planning, funding and service delivery considerations for networked services sit with the host district/network but the service is still provided for the State. A number of service users will therefore be from outside the host district/network’s catchment.

The transition from supra LHD service status to a networked service is based upon a review of the specific performance indicators, such as statewide access and service volumes and following discussion with the clinical lead and service provider. The final recommendation for a service to transition to a networked service will be made by the Committee to the Secretary.

Following approval to transition to a networked service there may be a need to monitor the service in the short term to ensure that activity and access to the service remain stable.

The process for transitioning a supra LHD service to a networked service will be transparent to ensure that the leverage associated with supra LHD service status is retained. This will include the expectations of the system with regard to supra LHD service provision and access. The movement of services on and off supra LHD service status supports a dynamic process for the uptake of new technologies and a culture of performance monitoring.


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5.3 Monitoring and Evaluation Framework Monitoring and evaluation are critical elements to assess the impact of the technology in relation to clinical outcomes, patient experience, cost effectiveness, and equity of access.

As with local technology assessment recommendations, the Ministry will develop a monitoring and evaluation plan that measures the impact of the technology across the domains of experience, outcomes and effectiveness and efficiency. Health outcome evaluation is included as a way of monitoring the longer term impact of the new health technology on relevant health outcomes and quality of life.

Evaluation methodology is guided by the NSW government evaluation guidelines primarily through the co-ordinated use of process and outcome evaluation.

Reporting will be aligned to existing data collections to minimise additional reporting requirements.

The district/network is responsible for service level monitoring consistent with local policies and procedures for Clinical Governance. This includes clinical aspects, adverse events and patient outcomes. Any proposed expansion to the agreed clinical indications will require review, and approval, by the Ministry, Clinical Lead (for supra LHD services) and Service Providers.


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5.4 Case study 2: Introduction of New Health Technologies – State Level

Autologous Haematopoietic Stem Cell Transplantation (auto-HSCT)

Auto-HSCT is an emerging technology for patients with autoimmune diseases, which has the potential to significantly impact the health system. This case study illustrates the identification and subsequent nomination of auto-HSCT for consideration by the Ministry, as well as the steps taken to implement and monitor this health technology following approval.

Step 1: Identify and Investigate

In 2014, the NSW Agency for Clinical Innovation (ACI) identified auto-HSCT as an emerging technology for patients with autoimmune disease. Auto-HSCT has numerous emerging clinical applications including systemic scleroderma, systemic lupus erythematosus and multiple sclerosis and high uptake which is likely to evolve.

Step 2: Assess

The ACI Blood and Marrow Transplant Network and the Ministry’s Health System Planning and Investment Branch (HSPIB) nominated auto-HSCT for review by HealthPACT who undertook a full health technology review. They concluded that auto-HSCT was an accepted treatment for severe scleroderma. This advice was provided to the Committee who recommended that the ACI and HSPIB undertake further work to assess the implementation of the technology in NSW.

Step 3: Service Planning

HSPIB and ACI collaborated to develop a comprehensive service model for auto-HSCT for patients with severe scleroderma in NSW. This included the development of: referral pathways, patient assessment processes and selection criteria, and a treatment protocol including follow-up care requirements.

In addition, HSPIB undertook an analysis of the anticipated volumes of procedures, service concentration and the location and experience levels of existing services for NSW.

Based on these analyses and on the basis of the recommendation from HealthPACT, HSPIB made the decision to establish a NSW supra-LHD service for eligible patients in NSW with severe scleroderma to receive auto-HSCT.

Step 4: Implement

The new supra LHD service for auto-HSCT for severe scleroderma was established in 2016/17. The activity levels for this service were purchased for 2016/17 via activity-based funding mechanisms and were included in Schedule D of the service agreement for the treatment site.

Step 5: Monitor and Evaluate

ACI and the Ministry are developing a monitoring and evaluation approach for the new supra LHD service in consultation with the treatment site. The Ministry and ACI also maintain a watching brief of the evidence for this technology in other autoimmune diseases.


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6. IMPLEMENTATION OF NEW HEALTH TECHNOLOGIES: LINKS TONATIONAL HEALTH TECHNOLOGY PROCESSESThe Ministry will leverage national health technology programs where appropriate, inparticular Health Technology Reference Group (HTRG) and the NFC program.

6.1 Health Technology Expert Reference Group All jurisdictions including NSW are members of HTRG, a sub-committee of the Australian Health Ministers’ Advisory Council (AHMAC), reporting directly to the Hospitals Principal Committee.

The HTRG was established to provide advance notice of significant new and emerging technologies to health departments in Australia and New Zealand. The HTRG provides jurisdictions with evidence-based advice to assist in evaluating the potential impact of emerging technologies on their respective health systems.

The Ministry nominates technologies for review by the HTRG who may undertake a “snapshot” update of a technology or complete a more comprehensive health technology assessment.

Pillars and district/networks are invited to nominate technologies that may benefit from a national review process by HTRG following assessment and recommendation through the two pathways described in this policy.

6.2 Nationally Funded Centres (NFC) Program The NFC is a national program, convened under the Australian Health Minister’s Advisory Council (AHMAC). The NFC provides access to high cost, low volume services that require a national population base for effective and efficient delivery. The program is funded by the states and territories on a population share basis.

New health technologies introduced in NSW via the Ministry’s health technology process may be suitable for nomination to the NFC Program if the technology requires a national population base for effective service delivery (i.e. the service would likely only be provided at one to two sites nationally to service the Australian population).

Nominations to the NFC Program are made by a jurisdiction (not an individual district/network, hospital or clinician). The Ministry will consider nominating new technologies for the NFC on a case-by-case basis. NFC nominations close annually on the second Monday of December.


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6.3 Case Study 3: Purchasing and Monitoring of Specialised Services

Planning for Peritonectomy Services in NSW

In NSW, peritonectomy with Heated Intraoperative Intraperitoneal Chemotherapy (HIPEC) is currently provided at one hospital in NSW.

In monitoring the implementation of HIPEC, a number of issues have been raised regarding

future service delivery including:

Model of care

Patient selection criteria

Emerging clinical indications

Workforce

Impacts for related clinical services

Future demand considerations.

Since implementation, there has also been an increase in patient activity, coupled with a

broadening of the patient selection criteria.

The resulting increase in service demand has warranted consideration and

appointment of a second site via an Expressions of Interest process.

A project to develop evidence-based recommendations to guide future purchasing decisions and delivery of peritonectomy services in NSW is currently in development with:

Cancer Institute NSW (clinical lead)

Local LHD

System Purchasing and Performance Division (SSPD)

Health System Planning and Investment Branch (HSPIB)


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6.4 Case Study 4: Supporting on-going Purchasing Decisions in Service Agreements

Adult Intensive Care Units with a statewide role are designated in the Policy Directive PD

2010_21 Critical Care Tertiary Referral Networks & Transfer of Care (Adults). These sites

are listed in Schedule D of the Service Agreements.

HSPIB and ACI work together to provide consolidated advice to the System Purchasing

and Performance Division to inform Service Agreement negotiations and to guide

purchasing considerations each year for these services.

This results in the identification of potential expansions for adult intensive care units

based on a combination of HSPIB’s statewide capacity analysis and ACI’s review of a

range of clinical indicators. This partnership ensures that the NSW Ministry of Health, as

System Manager, is able to make informed purchasing decisions within available

resources.


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APPENDIXES

1. NSW Health: New Technology Nomination Form

2. NSW Health Technology and Specialised Services Strategic Forum:Prioritisation & Assessment Matrix

3. NSW Health Emerging Technology Update Form

4. Annual Update & Nomination Schedule


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Appendix 1. NSW Health: New Technology Nomination Form

NSW Health invites Chief Executives of districts/networks and NSW Health pillars, and Deputy Secretaries of the Ministry to submit a New Technology Nomination for review by the NSW Health Technology and Specialised Services Committee.

Nominations are sought for health technologies with potential to significantly impact the NSW healthcare system and/or those that would benefit from further health technology review.

Please refer to the NSW Framework for New Health Technologies and Specialised Services (GL2017_20) for further information about the nomination process including technologies considered to be out of scope for review.

General requirements for nominations All materials accompanying an application must comply with privacy and

intellectual property principles and regulations

Information identifying individual patients is not to form any part of the application

Applicants understand that by submitting an application, all confidential, personalor proprietary information included are subject to the provisions of theGovernment Information (Public Access) Act 2009 (GIPA act)

Applicant must obtain manufacturer consent for information provided inapplications submitted to NSW Ministry of Health

Summary outcomes will be posted on the NSW Health Intranet new technologiessite following approval by nominating chief executives.

Should you have any further queries regarding the completion of this form, please email: [email protected]

Completed nomination forms can be emailed to: [email protected]

Note:

Nominations will only be accepted from the chief executive of a NSW Healthpillar, district, network, or a Deputy Secretary NSW Ministry of Health.

Nomination is the initial process in consideration of new technologies. If thenomination is prioritised for further consideration, more detailed informationwill be requested.

https://www1.health.nsw.gov.au/pds/Pages/doc.aspx?dn=GL2017_020

https://www.legislation.nsw.gov.au/#/view/act/2009/52

mailto:[email protected]



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1. GENERAL INFORMATIONNomination Contact Name

Position

Organisation

Address

Phone number

Email address

Clinical Contact Name

Position

Facility and Department

Phone number

Email address

2. NOMINATED TECHNOLOGY2.1 Name of Health Technology for Review

2.2 Purpose of Review The health technology is being nominated to the Committee for consideration for the

following reason/s (tick all that apply)

☐ potential for broad adoption of the technology

☐ technology that is currently delivered at very low volume and wouldbe appropriate for delivery at much greater volume

☐ there are factors that elevate the new health technology out of localplanning/budgeting capacity, such as specific specialised technical/ infrastructure requirements or significant financial investment

☐ NSW nomination of the technology to HTRG for national review

☐ technology likely to require service concentration for optimalservice provision in NSW

☐ current technology nominated for disinvestment or phasing down


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2.3 Technology Type (tick all that apply) ☐ implantable device ☐ approved device for use outside approved use

☐ medical or surgicalprocedure

☐ device provided on a trial period bymanufacturer

☐ treatment or diagnostic ☐ gene-based markers, therapies or diagnostic

Comments

2.4 Is the Technology currently available to NSW Public Patients?

☐ Yes summarise how the

technology is being delivered

i.e. special access scheme, clinical trial, non-clinical trial

current volumes andoutcomes.

☐ No summarise current availability

and reasons why public accessis not provided.

250 words max

2.5 TGA Approved for the Specific Clinical Scenario?

☐ Yes reference number

☐ No describe regulatory status, including

anticipated timeframe for TherapeuticGoods Administration approval and anyinternational approvals

specify the condition(s) that will be treatedby the technology


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3. NEW TECHNOLOGY OVERVIEWBrief description of the new technology:

Target population and clinical indication

Comparator technology

Expected outcomes – this should include a discussion on the safety, efficacy andcost-effectiveness of the new technology in comparison to the current standard of care

Results of local implementation

Impact of the technology on other services both short and long term.

500 words max

3.1 Patient Population(s) and Projected Demand Describe (as appropriate):

Incidence and prevalence in NSW of the target disease

Years of Life Lost and Disability Adjusted Life Years

Patient catchment, demographic, population and patient selection criteria

Anticipated annual volume and 5-10 year growth projections.


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4. LITERATURE AND EVIDENCESummarise available evidence using the modified PICO table below:

Reference Study Type Population Intervention and Control Outcomes

Analysis of ALL papers (200 words max)

Example

Reference Study Type Population Intervention and Control

Outcomes

Researcher et. al., A Journal 2018

Double blind randomised controlled trial

Adults with metastatic small cell lung cancer

Guided ultrasound radiotherapy vs intraoperative radiotherapy

5% reduction in absolute risk of all-cause mortality over 10 years

Analysis of ALL papers (200 words max)

Provide a brief analysis of the quality of the available evidence in relation to the target population. This should take into account study limitations, inconsistency in results, bias, indirectness of evidence and overall results. Consider using an established method to assess quality of evidence such as NH&MRC and/or GRADE.


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5. DISINVESTMENT AND/OR OFFSET OPPORTUNITIESDescribe (as appropriate):

Opportunities for disinvestment/offset and/or system savings

If the technology is in addition to or replacement of current technology

Impact on patient transfers between facilities.

6. FINANCIAL AND WORKFORCE IMPLICATIONSDescribe (as appropriate):

Anticipated financial impact, including estimated annual operating costs (when fullyoperational), offsets, net recurrent impact and capital requirements

Opportunities for system efficiencies or cost savings

Support and training requirements

Time required per case and impact on staffing

Training requirements.

7. OTHERProvide or attach any additional information you would like considered


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8. RISK ASSESSMENTDetail of your risk assessment and management plan

9. CONFLICTS OF INTERESTList of conflicts (as appropriate)

10. SHARING OF INFORMATIONThe Ministry would like to share a summary of this emerging technology update on the

New Health Technologies webpages; housed on the NSW Health Intranet. The purpose of

this is to increase the knowledge in the system and to facilitate collaboration.

Following the assessment process the Ministry will draft a summary of the technology.

The summary will not be shared without approval from the chief executive.

Final sign off for any content will sit with the Deputy Secretary, Strategy and Resources.

Circle approval

I consent / do not consent to the Ministry sharing an approved summary of this update

11. NOMINEE’S DECLARATIONI confirm the accuracy of the above information and consider that the nomination meets

the criteria for consideration through NSW Health’s new health technology evaluation

processes.

______________________________________ _______________ Signed (Chief Executive / Deputy Secretary) Date

Email completed nomination form to: [email protected]



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Appendix 2. NSW Health Technology and Specialised ServicesStrategic Forum: Prioritisation & Assessment Matrix

The Matrix is used by NSW Ministry of Health (the Ministry) and Health Technology and Specialised Services Strategic Forum to assist in the prioritisation of nomination technologies for further consideration: the higher the score, the higher the ranking.

Thorough review of clinical effectiveness, safety, assessment of current therapies, and cost effectiveness will be considered in the detailed health technology project if the nomination is prioritised to proceed to the next stage. The Matrix may be used locally or adapted for local use.

Principle Definition/considerations Circle Score descriptor

Clinical Need

The burden of illness of the target condition the technology applies to

- e.g. incidence, prevalence, Years of Life lost, Disability Adjusted Life Years.

Availability of alternative therapies to treat the nominated condition.

3 Significant burden of illness, limited availability of alternate therapies/diagnostics

2 Average burden of disease, some alternative therapies/diagnostics available though not optimal (significant side effects, inpatient therapy v outpatient)

1 Less significant burden of illness, other clinically and cost effective therapies/diagnostics available

Materiality The technology has the potential to make a material impact or significant difference in outcomes for the health system, the health service provider and the patient outcomes and experience.

3 High likelihood of material benefit in outcomes across the system and /or patient outcomes and experience

2 Average material impact across the system and/or patient outcomes and experience

1 Limited likelihood of material benefit to the system and/or patient outcomes and experience

Economic Feasibility

Likely level of investment - i.e. managed within existing

LHD resourcing or requiring investment from the Ministry or others.

3 Likely to require Ministry and Other investment - e.g. Commonwealth

2 Likely to require Ministry investment/resourcing

1 Likely to be managed from within existing LHD/SHN resourcing

Equity Statewide purchasing approach through the public hospital system necessary for equity of access for the target population.

3 Likely to be a highly specialised service in limited locations providing equitable access

2 Time-limited Ministry planning may benefit equity of access.

1 Technology likely to broadly diffuse in the system via local planning and clinical decision-making

Level of Evidence

Current level of evidence for the technology. Assessed according to the population available and the level of experience using the technology.

3 High. Evidence provided is of high quality with low risk of bias. Very confident that clinical claims are supported.

2 Moderate. Evidence provided is of moderate quality with some risk of bias. Moderately confident that clinical claims are supported.

1 Low. Evidence provided is of low quality with high risk of bias. Limited confidence that clinical claims are supported

0.5 Very Low. Quality of evidence is insufficient to support clinical claims.

Policy Congruence

The technology is consistent with Government priorities, Ministry priorities and/or NSW Health policy directives or guidelines.

3 Aligns with government, Ministry and/or NSW Health policy and/or priorities

2 Aligns with government/Ministry priorities, change in NSW Health policy may be required to accommodate the technology

1 Not aligned with government, Ministry and/or NSW Health policy and/or priorities

TOTAL SCORE


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NSW Health invites Chief Executives of districts/networks and NSW Health pillars, and Deputy Secretaries of the Ministry to submit an Emerging Technology Update. Updates are reviewed by the NSW Health Technology and Specialised Services Committee.

Emerging technology updates are a medium to provide the Ministry with information on new health technologies being implemented locally. It also provides an opportunity for further evaluation at a state and national level, and facilitates Ministry planning and decision-making.

1. GENERAL INFORMATIONContact Name

Position

Organisation

Address

Phone number

Email address

Clinical contact Name

Position

Facility and Department

Phone number

Email address

2. NAME OF HEALTH TECHNOLOGY

2.1 Technology Type (tick all that apply)

☐ implantable device ☐ approved device for use outside approved use

☐ medical or surgicalprocedure

☐ device provided on a trial period bymanufacturer

☐ treatment or diagnostic ☐ gene-based markers, therapies or diagnostic

Comments

Appendix 3. NSW Health Emerging Technology Update Form


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3. TGA APPROVED FOR THE SPECIFIC CLINICAL SCENARIO?☐ Yes ☐ No

3.1 Is the Technology the Subject of an Active Clinical Trial?

☐ Yes include details below:

☐ No

reference number: completion date: / /

additional information:

4. TECHNOLOGY OVERVIEWBrief description of the new technology, including:

Target population and clinical indication

Comparator technology (if applicable)

Expected outcomes – this may include a discussion on the safety, efficacy and

cost-effectiveness of the new technology in comparison to the current standard of care

Results of local implementation and evaluation results to date

How the technology impacts or links with other services both short and long term

(if applicable).

500 words max


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5. OTHERDescribe or attach any additional information you would like to include

6. CONFLICTS OF INTERESTList of conflicts (as appropriate)

7. SHARING OF INFORMATIONThe Ministry would like to share a summary of this emerging technology update on the

New Health Technologies webpages; housed on the NSW Health Intranet. The purpose of

this is to increase the knowledge in the system and to facilitate collaboration.

Following the assessment process the Ministry will draft a summary of the technology.

The summary will not be shared without approval from the Chief Executive.

Final sign off for any content will sit with the Deputy Secretary, Strategy and Resources.

Circle approval

I consent / do not consent to the Ministry sharing an approved summary of this update

8. NOMINEE’S DECLARATIONI confirm the accuracy of the above information and consider that the nomination meets

the criteria for consideration through NSW Health’s new health technology evaluation

processes.

______________________________________ _______________ Signed (Chief Executive / Deputy Secretary) Date

Email completed emerging technology updates to: [email protected]



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Appendix 4. Annual Update & Nomination Schedule

Update/Nomination schedule Month Committee meeting schedule

Call for Emerging Technology Updates

May/June

Updates Close August Health Technology and Specialised Services Committee meeting – review of updates

Call for Nominations from within the Districts, Networks Ministry and Pillars

September

Nominations Close November Health Technology and Specialised Services Committee meeting

March Health Technology and Specialised Services Committee meeting – review of nominations

Outcome of Nominations Advised

April/May

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