We have developed a number of initiatives to support evidence-based treatment decisions by NICE and other policy customers’ health and social care assessment processes.
Collaborations for Leadership in Applied Health Research and Care
The 13 regional Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) bring their academics together with NHS providers and commissioners, local health and social care organisations, industry and third sector partners, health research infrastructures, and local Academic Health Science Networks (AHSNs). CLAHRCs carry out applied research and evidence-based implementations that are responsive to, and in partnership with, their collaborating organisations, patients, carers and the public, and translate research findings into improved outcomes for patients.
Technology Assessment Reviews
The NIHR Technology Assessment Review (TAR) teams provide evidence to support NICE and other policy customers’ health and social care assessment processes. There are nine TAR Teams, with eight based in England and one in Scotland.
The reviews independently assess the existing evidence base on the benefits, harms and costs of particular healthcare treatments and tests for those who plan, provide or receive care in the NHS. TARs inform the National Institute for Health and Care Excellence (NICE) Appraisal Committee guidance on the use of new and existing medicines, treatments and procedures within the NHS in England and Wales. Each TAR is tailored to meet the individual policy customer’s needs in terms of independent evidence review, individual patient meta-data analysis, cost-effectiveness and economic modelling.
Tranexamic Acid (TXA) in trauma - CLAHRC South West Peninsula
CLAHRC South West Peninsula (PenCLAHRC) supported the use of tranexamic acid (TXA) by paramedics and others involved in emergency care for trauma patients, saving approximately 400 lives a year in the UK (CRASH-2 trial data). Previous research had shown that, if used within three hours after trauma, TXA reduces the risk of death from bleeding by as much as 30 percent. Despite the costs being low and there being virtually no side-effects, there had been little implementation within the NHS. After an initial review of the evidence, it was decided that an effective way of delivery would involve the drug being administered by paramedics as well as in A&E, using a protocol that has been agreed upon with emergency departments.
CLAHRC South West Peninsula worked with the South West Ambulance Service NHS Foundation Trust (SWAST) and the acute trusts to support all emergency services in the south west in carrying TXA. As a result of this work, all emergency ambulances across Devon, Cornwall, the Isles of Scilly, Somerset and Dorset started to carry TXA and all hospital trusts introduced it into their emergency departments as well as developing local guidelines and protocols for its use.
As a result of this successful implementation, the use of TXA was incorporated into the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) National Guidelines for use across the UK. All emergency ambulance services across England now carry TXA, saving lives in the most extreme cases of injury.