3 Adoption support resources: topic selection

3.1 Topic research

Adoption support resources support the implementation of health technologies that NICE has recommended.

For each selected guidance topic, a health technology adoption manager researches the topic in detail. This gives a better understanding of current practice and issues relating to the adoption of a new technology. Information is gathered from a variety of sources, including:

  • guidance notification, scope and draft guidance

  • published NICE guidance and implementation support covering relevant areas of practice

  • local and national health and social care policies, strategies, legislation and regulation

  • epidemiological data on prevalence and incidence

  • the adoption and impact reference panel (see appendix B)

  • users of the technology advised by the notifying company.

The health technology adoption manager should understand existing care pathways and services before the technology selection meeting. They should also know about service models that may exist across the different settings and how the service may be funded or commissioned.

3.2 Topic selection meeting

Adoption support resources are developed for technologies that present the most significant changes to current practice or have the most financial impact. The adoption team selects which technologies will need adoption support after the final guidance scope has been published by NICE. This is carried out at a topic selection meeting attended by adoption team staff. The technical analyst from the relevant programme is also invited to attend and, where appropriate for medicines, an advisor from the medicines and prescribing team.

The purpose of the topic selection meeting is to discuss, agree and document factors considered in sections 3.2.1, 3.2.2 and 3.2.3.

3.2.1 The need for an adoption support resource

The adoption team considers a range of criteria to identify the need to produce an adoption support resource.

A topic selection tool is used to inform discussions and to document the decision. This enables individual technologies, or groups of technologies used for a named clinical condition, to be prioritised based on a set of questions about the complexity of adoption and its potential impact.

The following criteria are considered for selection:

  • The need for substantial care pathway redesign.

  • Changes in commissioning arrangements (including budget transfers to fund the technology and decommissioning services).

  • Potential financial savings.

  • Complexity of funding arrangements.

  • Significant barriers to adoption that need to be overcome in order to allow wide‑scale adoption, for example retraining large sections of the workforce, decommissioning services and physical changes to clinical areas.

These considerations help to identify what the likely impact of adoption will be and whether an adoption support resource is needed. Technologies are likely to be selected if implementation would lead to significant changes to existing health and social care services.

3.2.2 The type of adoption support resource

If the technology, or group of technologies, is already in use in heath or social care services, an adoption support resource with case studies is developed. A number of factors will be taken into account when deciding if this approach is appropriate, including:

  • The number of health or social care organisations already using the technology.

  • How long the organisations have been using the technology for.

  • Whether the technology has been adopted in a sustainable way and in line with NICE guidance.

  • The scale of adoption within these organisations, for example the number of devices being used, the target patient population and actual patient population using the technology.

  • Whether these organisations can provide useful experience and advice on putting the technology into practice.

Where the technology, or group of technologies, is not already being routinely used in UK health and social care services, the team works with expert practitioners to identify the considerations that would be important for successful adoption and instead produce an adoption support resource without case studies.

3.2.3 When to publish the adoption support resource

Adoption support resources for the medical technologies evaluation programme (MTEP) and diagnostics assessment programme (DAP) are published either at the same time as the guidance or after it. This depends on the complexity of adopting the technology and on any changes to draft guidance recommendations.

All adoption support resources for technology appraisals are published after the guidance.

At times the adoption team may need to prioritise the publication of topics according to the team's capacity, and this will inform the decision about whether the resource publishes at the same time or after guidance.

3.2.4 Support for shared learning development

If, during guidance scoping, the adoption team has identified health or social care organisations using the technology but an adoption support resource is not going to be produced, the health technology adoption manager will encourage and help practitioners to submit their example to the NICE local practice collection database.

3.3 Communicating the outcome of topic selection

The adoption team informs the relevant guidance team of the outcome of topic selection and the sponsor is informed by the guidance team.

3.4 Reviewing the topic selection decision

The topic selection decision is reviewed and reconsidered in the following circumstances:

  • If there is a change in the draft guidance as a result of consultation.

  • If there is any new information provided at guidance committee meetings that identifies significant cost considerations or adoption issues that had not been previously identified.