Journal of Wound CareVol. 25, No. 11 Generic Programme UpdateFree AccessNHS Clinical Evaluation Team: what's going on?Camila FronzoCamila FronzoSearch for more papers by this authorCamila FronzoPublished Online:9 Nov 2016https://doi.org/10.12968/jowc.2016.25.11.597AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail Just over a year ago, the NHS Supply Chain posted a letter1 on its website introducing a plan to develop a set of generic national specifications classed as ‘clinically acceptable’ and ‘fit for purpose’ for seven wound care and dressing categories. The project, inspired by Lord Carter of Coles’ Interim Report,2 was meant to develop a generic selection of wound care products, based on the assumption that they would ‘provide a best value benchmark across the NHS, and have the potential to deliver 10–20% savings for NHS providers.’In April, when asked about the progress of this proposal, a spokesperson for the Department of Health (DH) told the Journal of Wound Care (JWC):‘We are helping to improve patient care by reducing the complexity around product choices that leads to variation. A new NHS Clinical Evaluation Team (CET) is assessing the wound care products used in the NHS, with input from NHS clinical staff, to provide a benchmark across the NHS to ensure the best possible outcome for patients.’That same month, the CET introduced its members at the Tissue Viability Society (TVS) conference in Cardiff. Mandie Sunderland, Chair of the Clinical Reference Board, part of the NHS Customer Board for Procurement and Supply, briefly explained the objectives of the CET, which did not include the development of a national formulary for wound care, as suggested by the NHS Supply Chain's letter,1 dated October 2015. However, there was still confusion surrounding the CET's work—its initial reports will be published on the 16th December—and how its outcomes would affect the wound care field.Simon Hall, Clinical Specialist Lead at CET, spoke to JWC to clarify the impact that the project will have.Q What is the main role of the CET, and what have you been working on since last April?A Our role is to evaluate some of the everyday health-care consumables3 used by clinicians. To prioritise these, we considered volume of use and extent of use in clinical environments to shape the order of product evaluations.All products for review have been following a 5-step process4 from identification through evaluation to outcome. The outcomes and reports produced will be freely available to clinicians and trusts, health organisations and suppliers.Q Which products is the CET reviewing?A The scope of our programme at this stage—the initial 6 months—is to only review those products available through a national supplier route, and for this project, the national supplier identified was the NHS Supply Chain. This was chosen to ensure that clear parameters and structure existed around the products for review, but the template could also be applied to those products outside the national supplier framework. The full list of products can be accessed through our website.3Q What is the criteria used in this product review?A There are many suppliers with large portfolios of products. There is a lot of information produced by these suppliers on products available, and, in many ways, there is too much. It can be hard and time consuming for clinicians to compare a product's performance to its peers, especially when some of the easily available supplier data compares itself to one or two counterparts, or the market leader on specific features of the products. Furthermore, there can be a lot of differing opinions with suppliers often having opposing reports, making it hard to know the quality and validity of this information.This year, the National Institute for Health and Care Excellence (NICE) published a report5 highlighting some of the limitations of dressing efficacy. Acknowledging that while dressings are broadly considered a medical device for which randomised controlled trials (RCTs) are a standard requirement, in dressings this is not the case, and of those that are conducted there is the use of ‘inappropriate comparators in RCTs’.One of the concepts of the CET is to review these data, to see what information is already available and then to engage with clinicians, ranging from specialist tissue viability nurses to allied health professionals and general nurses, in order to develop a picture of what they actually require the products to do. By sampling a large range of health professionals, we hope to capture some of the more detailed performance criteria, as well as the more baseline fundamentals. Regional events were hosted around the England to best achieve this broad view and reduce the risk of obtaining merely a regional opinion.The aim of both this literature review and the clinical engagement events was to develop a criteria, so that all products could be tested and compared with this ‘clinical national standard’ rather than compared against each other.Q How will this information improve or help the NHS?A Firstly, it will assist clinicians in making an informed choice when purchasing products by giving them a clear tool to make the decision based on the requirements for their particular clinical area. The requirements of products in any given category will vary depending on the patient, the wound and the clinical environment in which products are being used. For example, for a patient in an acute hospital with a wound viewed on ward round twice a week, dressing features may differ from the same patient being seen by their district nurse once a week. Clinicians should be able to make this decision faster, and have greater knowledge and understanding of the product features and potential limitations, which will result in greater patient experience, enhanced nurse knowledge, confidence in treatment plan and, ultimately, better patient outcome. Patient outcome may be a subjective statement, as a good outcome may not necessarily be wound healing, but may be focused around other outcomes, such as enhanced quality of life, reduction in frequency of dressing changes, enhanced exudate management, greater comfort/conformability, odour control, less waste, increased liberty with better wound management and less clinical involvement.In addition, the time and process for each clinical environment or region to select products for their given area/formulary will be faster, as they can use this tool alongside their knowledge to make quicker decisions on products, releasing more clinical time.As the team's process and outputs are completely transparent, this tool and the features/clinical criteria will be freely available to suppliers, which may help them in future product development. They will be able to use this information to truly see what clinicians require on a national level. This degree of information on this scale has not been available before.Q What is the difference between your project and the NHS Supply Chain's?A The CET is an NHS programme funded by the DH, which operates independently of the NHS Supply Chain. It is ‘for the NHS, by the NHS’, and is not aligned to other programmes or projects that have been undertaken by the NHS Supply Chain.The NHS Supply Chain has been identified as a stakeholder in the CET programme, and we have asked them to share some information like many suppliers have shared information on their products, as part of our intelligence-gathering exercise.The team members are truly impartial, having no bias or allegiance with any supplier, clinician or distributor.Q Will the outcomes of your review limit product choice in wound care?A Our remit is to assess quality of products, and this is against a defined clinical criteria developed by stakeholders, clinicians and suppliers. It is to be used as a tool to educate, advise and guide, to enhance clinical choice and give greater clarity on the performance and delivery of products. It is not to dictate or recommend the use or disuse of everyday health-care consumables.We welcome readers' comments on this programme. These should be emailed to [email protected] References 1 NHS Supply Chain 2015. National wound care and dressings generic specification to establish “clinically acceptable” standard. http://bit.ly/1GSROol (accessed 4 October 2016). Google Scholar2 Lord Carter of Coles. Review of Operational Productivity in NHS providers. Interim Report June 2015. Available at http://bit.ly/1fe92oU (accessed 4 October 2016). Google Scholar3 NHS Clinical Evaluation Team. Everyday healthcare consumables. Available at http://bit.ly/2dMEGLH (accessed 4 October 2016). Google Scholar4 NHS Clinical Evaluation Team. Requirements & evaluation pathway. Initial 5 stage process. http://bit.ly/2dy9qyk (accessed 4 October 2016). Google Scholar5 National Institute for Health and Care Excellence (NICE). Chronic wounds: advanced wound dressings and antimicrobial dressings. http://bit.ly/2dyc9rx (accessed October 4 2016). Google Scholar FiguresReferencesRelatedDetails 2 November 2016Volume 25Issue 11ISSN (print): 0969-0700ISSN (online): 2052-2916 Metrics History Published online 9 November 2016 Published in print 2 November 2016 Information© MA Healthcare LimitedPDF download