Title: NIHR Community Healthcare MedTech and In Vitro Diagnostics Co-operative (short name: NIHR Community Healthcare MedTech and IVD Co-operative)
Funder: Department of Health and Social Care

Abstract: Hospital-based clinicians are usually able to use a wide range of diagnostic tests for making accurate and prompt diagnoses. Community based clinicians, on the other hand, manage over 90% of NHS patient contacts often without timely access to diagnostic tests, which results in delays in making the right diagnoses and in making treatment decisions that are best for patients. New developments in diagnostics are promising to revolutionise the amount and quality of care that we can deliver in the community. However, all too often, diagnostic test development is driven by technological innovation and financial considerations rather than real, unmet clinical needs. Test evaluations usually just confirm that the test provides accurate measurements, and seldom go on to show that the test actually benefits patients. Thus, many new tests are not taken up into routine care, wasting resources. It is critical therefore that companies developing new tests intended for community use have input from experienced researchers, users, and clinical experts all the way from the initial concept through development, evaluation, marketing, and beyond. We propose a highly ambitious, multidisciplinary, supportive MIC that will identify critical unmet needs for tests in community healthcare settings, help develop new tests that will meet such needs, and collaborate with the NHS and companies to help make sure that commercially available tests really will transform community healthcare before they become part of routine care. We are an effective, integrated group of doctors, nurses and service users at the frontline of community healthcare; researchers skilled at developing and evaluating tests; and networks with a remit to improve healthcare by promoting innovation. Our statistical and health economics expertise will help partner companies understand where both new and existing tests would be most cost-effective &ndash; be it in the home, pharmacies, the GP surgery, or at ambulatory units, so that patients in the community can receive hospital standard care. Service users will be central to prioritising which projects we work on and in guiding development and evaluations of new diagnostic technology for enhancing care in the community. Our initial priorities will be in areas of community medicine where new tests have the greatest chance of improving care. Our four main clinical themes will be: acute childhood illness, supporting doctors to limit unnecessary antibiotics, diagnosing and managing chronic disease, and supporting new ambulatory models of care. These clinical pillars will be supporting by two cross cutting themes that will focus on identifying and addressing unmet needs, and developing better methods for evaluating tests. An enabling, multidisciplinary platform of statisticians, social scientists, health economists, public contributors, and systematic reviewers will support the aims of our themes, so that academic and industrial partners become more efficient in developing tests and demonstrating patient benefit. Short term priorities include engaging with companies, identifying areas of unmet needs and tests which require evaluation. In the long term we will become a national resource for developing and evaluating tests that have genuine positive impact on community health services and quality of life for patients.

Lay abstract: Hospital-based clinicians are usually able to use a wide range of diagnostic tests for making accurate and prompt diagnoses. Community based clinicians, on the other hand, manage over 90% of NHS patient contacts often without timely access to diagnostic tests, which results in delays in making the right diagnoses and in making treatment decisions that are best for patients. New developments in diagnostics are promising to revolutionise the amount and quality of care that we can deliver in the community. However, all too often, diagnostic test development is driven by technological innovation and financial considerations rather than real, unmet clinical needs. Test evaluations usually just confirm that the test provides accurate measurements, and seldom go on to show that the test actually benefits patients. Thus, many new tests are not taken up into routine care, wasting resources. It is critical therefore that companies developing new tests intended for community use have input from experienced researchers, users, and clinical experts all the way from the initial concept through development, evaluation, marketing, and beyond. We propose a highly ambitious, multidisciplinary, supportive MIC that will identify critical unmet needs for tests in community healthcare settings, help develop new tests that will meet such needs, and collaborate with the NHS and companies to help make sure that commercially available tests really will transform community healthcare before they become part of routine care. We are an effective, integrated group of doctors, nurses and service users at the frontline of community healthcare; researchers skilled at developing and evaluating tests; and networks with a remit to improve healthcare by promoting innovation. Our statistical and health economics expertise will help partner companies understand where both new and existing tests would be most cost-effective &ndash; be it in the home, pharmacies, the GP surgery, or at ambulatory units, so that patients in the community can receive hospital standard care. Service users will be central to prioritising which projects we work on and in guiding development and evaluations of new diagnostic technology for enhancing care in the community. Our initial priorities will be in areas of community medicine where new tests have the greatest chance of improving care. Our four main clinical themes will be: acute childhood illness, supporting doctors to limit unnecessary antibiotics, diagnosing and managing chronic disease, and supporting new ambulatory models of care. These clinical pillars will be supporting by two cross cutting themes that will focus on identifying and addressing unmet needs, and developing better methods for evaluating tests. An enabling, multidisciplinary platform of statisticians, social scientists, health economists, public contributors, and systematic reviewers will support the aims of our themes, so that academic and industrial partners become more efficient in developing tests and demonstrating patient benefit. Short term priorities include engaging with companies, identifying areas of unmet needs and tests which require evaluation. In the long term we will become a national resource for developing and evaluating tests that have genuine positive impact on community health services and quality of life for patients.

Research activity codes: 4.5 RESOURCES AND INFRASTRUCTURE (DETECTION)
Health categories: GENERIC HEALTH RELEVANCE