NICE medical technologies guidance addresses specific technologies notified to NICE by sponsors. The 'case for adoption' is based on the claimed advantages of introducing the specific technology compared with current management of the condition. This case is reviewed against the evidence submitted and expert advice. If the case for adopting the technology is supported, then the technology has been found to offer advantages to patients and the NHS. The specific recommendations on individual technologies are not intended to limit use of other relevant technologies which may offer similar advantages.
1.1 The case for adopting the Ambu aScope4 Broncho for use in people with unexpected difficult airways needing emergency intubation is supported by the evidence. This shows that the Ambu aScope4 Broncho is an acceptable alternative, where a multiple-use fibre optic endoscope is unavailable. There are also advantages during replacement of dislodged tracheostomy tubes in the intensive care setting. Making the Ambu aScope4 Broncho available for use across settings is likely to improve outcomes and patient safety.
1.2 Adoption of the Ambu aScope4 Broncho is supported by cost modelling for a range of common clinical settings in which there is no multiple-use endoscope or where existing multiple-use endoscopes are not available. These settings are: isolated units, operating theatre units, and intensive care units, where the uses include the repositioning of displaced tracheostomy tubes. Although there were some uncertainties in the cost modelling, cost savings are likely in all settings modelled. The amount saved will depend on the number of intubations performed and on the number (if any) of existing multiple-use fibre optic endoscopes in use.
1.3 The details of the cost modelling and estimated cost savings for each clinical setting are described in sections 5.16 to 5.20. Section 5.21 presents the details of the revised cost modelling. As an example of the clinical area where savings could be greatest, using the Ambu aScope4 Broncho in the intensive care setting is estimated to be cost saving (£6,632 per year) when more than 700 intubations are conducted each year, when there are 2 or fewer existing multiple-use fibre optic endoscopes, and assuming that 5% of intubations are difficult.