Getting It Right First Time (GIRFT) – implementation of GIRFT and MedTech Funding Mandate policy around minimally invasive surgery for BPH in the UK

Abstract

The MedTech Funding Mandate (MTFM) policy was introduced in 2021 by the National Health Service (NHS) England, to facilitate the adoption of innovative, cost-saving medical technologies approved by the National Institute for Health and Care Excellence (NICE) within the NHS. This policy aligns with the objectives of the Getting It Right First Time (GIRFT) initiative, which aims to improve clinical effectiveness by reducing unwarranted variations in healthcare practices. In April 2022, the MTFM policy included four technologies for the treatment of bladder outlet obstruction (BOO). These technologies offer clinical effectiveness, resource efficiency, and affordability, as recommended by NICE. Despite the availability of NICE-approved minimally invasive surgical treatments (MISTs) for BOO, transurethral resection of the prostate (TURP) remains the commonest surgical treatment for BOO, although there is debate as to whether this remains the gold-standard of care. The inclusion of the four BOO technologies in the MTFM policy aims to address the existing inequalities in patient access to NICE-approved treatments and support the adoption of these effective alternatives to monopolar TURP. Key stakeholders, including GIRFT, Urology Area Networks (UANs), and the 15 Academic Science Networks (AHSNs), play a crucial role in implementing the MTFM policy. The policy has significant implications for clinical practice, promoting pathway transformation, resource and cost savings, and a comprehensive range of treatment options for patients with BOO.