NICE process and methods

2 Strategy for medical technologies topic intelligence

2.1 Topic intelligence describes the activity done to proactively and systematically gather information on an agreed subject focus. The aims of this activity are to rapidly identify priority areas for health and social care and corresponding medical technologies which are suitable for national evaluation and validate these topics and technologies with a range of stakeholders in the health and care system. Technologies will then be considered for advice or guidance.

2.2 The topic intelligence process brings together 3 domains (see appendix 1, figure A):

  • Issues in health and social care – an understanding of unmet or partially met clinical, system or service user needs, identified through strategic engagement with the health and care system.

  • Top health and care policy priorities, established and validated through broad engagement with key policy teams in the NHS and social care sectors.

  • Suitable technologies, which are systematically searched for from a variety of sources and filtered for evaluation by NICE.

The vision

2.3 NICE will take a deliberative and systematic approach, selecting and supporting relevant health system priorities. This will help ensure NICE resources are focused on areas of greatest need for new innovations to improve care.

2.4 The topic intelligence function aims to deliver this vision by providing a capability within NICE to:

  • develop networks to generate intelligence streams on key topic areas to better understand system priorities (service or clinical needs).

  • proactively scan for devices, diagnostics, and digital health technologies which meet system priorities.

  • carry out targeted engagement with the wider system to confirm the right topics are being considered for various work programmes, helping NICE to focus resources on the most impactful outputs.

    This structured approach to topic intelligence will optimise the inward flow of technologies to NICE for the benefit of the health and care system.

Topic intelligence for early value assessment

2.5 The initial focus for topic intelligence was on rapidly identifying digital health technologies that would address system priorities in cardiovascular disease, mental health, and post-COVID system recovery.

Topic intelligence process

2.6 The topic intelligence process is a 4-step process to produce a comprehensive output that is useful to multiple NICE teams. The process involves different teams gathering information on the domains shown in figure 1.

Figure 1. Summary of topic intelligence process

Abbreviations: PICO – population, intervention, comparator, and outcomes

Topic priority: the problem

2.7 Topic intelligence activity must begin with identifying a clinical, system or service user problem to help direct NICE resource to topics which will be of greatest value to the health and social care system.

2.8 This activity will build intelligence on the following areas:

  • Priority topic areas, for example, by health inequality, clinical specialty, or system pressure, incorporating key national policy priorities, activity data from the system, epidemiology data on burden of disease.

  • Unmet need for the topic area, for example, lack of access to diagnostics or treatments, long waiting lists, suboptimal outcomes with current standard of care.

  • Scale and impact of the problem, for example, national compared with regional compared with local and implications for inequalities.

2.9 Each topic area is described as an unmet clinical need in a specialty area (for example, cancer, ophthalmology) or a system need (for example, system recovery, long referral-to-treatment times). This information should ideally correspond to national priorities such as the NHS Long Term Plan and core NHS strategies such as Core20plus5.

2.10 Each area of need is focused into a specific review question and articulated further using a population, intervention, comparator and outcome (PICO) framework or other relevant frameworks, considering the scale and potential impact on the system.

2.11 Topic priorities are identified through engagement at a senior level with the health and social care system.

Identification of technologies

2.12 The topic intelligence hub database will support the systematic logging of all topic intelligence activity for both technology trawls and engagement.

2.13 A search for appropriate technologies which could meet unmet needs of the health and care system will be done through extensive external and internal engagement with the organisations listed in appendix 1, table 1. High-level criteria are used to initially identify the technologies, with minimum requirements as follows:

  • The technology meets appropriate regulatory requirements (for example, UKCA or CE mark) appropriate to the function.

  • The technology falls within a priority area.

  • The technology is currently being used in the NHS or being planned for uptake in the coming 6 months.

Filtering technologies

2.14 Technologies are filtered based on priority area, regulatory information, use in the NHS and social care, funding and evidence (see appendix 1, table 2). Information on these criteria is extracted from public domain sources wherever possible, to avoid generating expectations from companies. Technologies will subsequently be reviewed by the topic selection oversight panel.

Understanding the data collection landscape

2.15 The current availability of data and plans for collecting data are both important considerations around assessing technologies and making appropriate recommendations on future evidence generation. Where available, this will be included in the topic intelligence activity.

System validation

2.16 The validation of the topic areas and technologies with policy drivers and system leaders will ensure NICE is moving cohesively with the health and care system. It is more likely that such priorities will get system support, either through resource, funding, or consensus agreement.

2.17 Additionally, system engagement at the ground level is critical for generating consensus among key stakeholders on the topic areas and technology lists and may help identify testbeds for the programme outputs from NICE.

Commercial surveillance

2.18 Surveillance of commercial activity in the devices, diagnostics, and digital health technologies sector is not routinely done within NICE. There has been ad hoc reporting of large-scale industrial investment in areas such as virtual wards, done by the strategy team. This type of intelligence is useful for signalling where there is likely to be a surge in activity after large investment in a particular sector, hence may benefit from topic intelligence activity. NICE topic intelligence and strategy teams can jointly support this activity.

Topic feeds and outputs within NICE

2.19 The NHS Innovation Service, launched in July 2022, is the centralised source of innovation information for the health and care system and is being referred to accordingly. This will become a key source of intelligence for NICE work programmes and provide a means through which to engage with system partners on common priorities.

2.20 There are also existing internal topic feeds for topic intelligence within NICE from current workstreams, for example, from the Office for Market Access team, Interventional Procedures programme, Scientific Advice and so on. These will continue to be used as sources for both topic areas and technology feeds.

2.21 Summaries of the topic intelligence activity will be shared with NICE's Medical Technologies Evaluation Programme and Diagnostic Assessment Programme, Centre for Guidelines, NICE Scientific Advice and Office for Market Access as relevant.

2.22 Different work programmes will have different requirements of the information provided, and identified technologies will be managed in line with NICE's topic selection process and methods. The topic selection oversight panel will remain responsible for topic selection including selection of early value assessment topics.

Engagement framework

2.23 The topic intelligence team routinely engages with relevant networks (see table 1 in the appendix). These information sources have been invaluable for gathering insights on technologies and for understanding how different NICE programmes could align to the system, and vice versa.