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激励英国国家医疗服务体系采用创新:加速准入审查中期报告建议的可行性与实用性

Galvanising the NHS to Adopt Innovation: The Feasibility and Practicality of Recommendations from the Interim Report of the Accelerated Access Review.

作者信息

Parris Stuart, Cochrane Gavin, Marjanovic Sonja, Ling Tom, Chataway Joanna

出版信息

Rand Health Q. 2016 Jun 20;6(1):8.

Abstract

The Department of Health and the Wellcome Trust, in co-operation with NHS England, asked RAND Europe to conduct a limited consultation with key stakeholders about the practicality of measures and incentives proposed as part of the NHS Accelerated Access Review (AAR), which aims to assess the pathways for the development, assessment, and adoption of innovative medicines and medical technology. Through a focused engagement exercise with key healthcare stakeholders this project explored the implications of selected interim AAR propositions and feasibility of implementation for key actors, in primary and secondary care as well as commissioners and academia. Specifically, the project investigated the feasibility of implementation of three specific propositions including: a new earmarked fund to encourage AHSNs and other key innovation actors to re-design systems to embrace innovation; mobilising the influence of clinical system leaders to champion change; and encouraging secondary care organisations to take on "innovation champion" roles linked to financial incentives and a new emphasis on accountable care organisations. Data was collected on the feasibility of the three AAR propositions from a workshop with AHSN CEOs and Commercial Directors and interviews with senior NHS staff in three AHSN regions (South West, University College London Partners, and North East, North Cumbria). The study concludes with reflections on the feasibility of each recommendation and identifies factors expected to facilitate or challenge their implementation, as well as considering the wider cross cutting issues that may influence the adoption and diffusion of innovation in the NHS.

摘要

英国卫生部和惠康基金会与英国国民医疗服务体系(NHS)英格兰合作,委托兰德欧洲公司与主要利益相关者就作为NHS加速准入审查(AAR)一部分提出的措施和激励措施的可行性进行有限的磋商。该审查旨在评估创新药物和医疗技术的研发、评估及采用途径。通过与关键医疗利益相关者进行有针对性的参与活动,该项目探讨了AAR选定的中期提议对主要和二级医疗保健机构、专员及学术界等关键行为者的影响以及实施的可行性。具体而言,该项目调查了三项具体提议的实施可行性,包括:设立一项新的专项资金,以鼓励学术健康科学网络(AHSNs)和其他关键创新行为者重新设计系统以接纳创新;调动临床系统领导者的影响力以推动变革;鼓励二级医疗保健机构承担与经济激励措施相关的“创新倡导者”角色,并重新强调问责制医疗组织。通过与AHSN首席执行官和商务总监举办的研讨会以及对三个AHSN地区(西南地区、伦敦大学学院合作伙伴地区以及东北部和北坎布里亚地区)的NHS高级工作人员进行访谈,收集了有关三项AAR提议可行性的数据。该研究最后对每项建议的可行性进行了思考,确定了预计会促进或阻碍其实施的因素,并考虑了可能影响NHS创新采用和推广的更广泛的交叉问题。

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