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Journal of Public Health Advance Access originally published online on February 27, 2007
Journal of Public Health 2007 29(2):157-164; doi:10.1093/pubmed/fdm001
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© The Author 2007, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

A rapid needs assessment of the provision of Health Technology Assessment in the south-west peninsula



Julian Elston, Honorary Research Fellow

Ken Stein, Senior Lecturer in Public Health
Institute of Health and Social Care, Peninsula Medical School, Barrack Road, Exeter EX2 5DW, UK

Address correspondence to Julian Elston, E-mail: julian.elston{at}nhs.net


  Abstract

Background Key to delivering UK policies on clinical governance, evidence-based practice and value for money is Health Technology Assessment (HTA). Despite the provision of HTAs through the National Institute for Health and Clinical Excellence (NICE), local health organizations still undertake HTA and make decisions based on them. In some regions, capacity is provided by centralized arrangements, but in others provision is ad hoc. This rapid needs assessment evaluates the provision of HTA in the south-west peninsula, and its scope, content and quality.

Methods We used semi-structured interviews and documentary analysis to assess the need for HTA.

Results HTAs are most commonly used by drug and therapeutics committees and joint formulary committees. The scope of technologies assessed was predominantly drugs. The quality of literature review in HTAs was variable and virtually none considered value for money. Informants felt there was insufficient provision of local HTAs. Local focus and clinical engagement were seen as key to the implementation of appraisal decisions, but this was threatened by weak links with commissioning and processes to prioritize decisions across primary care trusts.

Conclusions The quality of some HTAs poses a risk to clinical and corporate governance.

Keywords: needs, assessment, rapid, Health Technology Assessment, decision-making, evidence


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