NDoH POLICY: HEALTH TECHNOLOGY MANAGEMENT AND HTA

Transcription

1 NDoH POLICY: HEALTH TECHNOLOGY MANAGEMENT AND HTA SAMED 2015 CONFERENCE S BAKHANE Directorate: Health Technology Policy National Department of Health 26 AUGUST 2015

2 VISION AND MISSION FOR HT Vision Appropriate, safe and cost effective health technology available at the point of need. Mission To position HT as a key enabler of quality and affordable health service delivery by creating a national health technology system; facilitating safe and appropriate utilization of health technology ; promoting the optimal distribution of the limited HT resources to facilitate equity in access.

3

4 Promoting Equity In Access & Distribution Of HT (HT Planning) HT market (Billions p.a), large % in Public sector Poor planning No rational basis and mechanisms for HT replacement & procurement (sales people driven) Mismatch b/n the need and the available technologies, Tendency to buy high tech and expensive equipment High tech equipment purchased, unused (skills shortage) Indiscriminate introduction and use of technology Proliferation of technology, driving up the cost of health care. (Private sector & Public Sector

5 Inappropriate Procurement Radiological / Fluoroscopic Unit Status: new, unused Cost: R Age: 3 years Waste-Disposal Units, Sharps Status: None Cost: R 300 Requirement: 300

6 HT Planning Goals Develop a Technology Planning mechanism (Norms & Stds) Develop a National HT Plan Build planning capacity Establish national HT inventory Develop relevant HT packages (EELs etc) Critical Success Factors Conduct a comprehensive HT Audit Establish multidisciplinary HT Planning Committees for all levels

7 Reduction Of The High Cost Of HT (HT Acquisition) Fragmented medical device acquisition & poor control mechanisms (corruption-risk) Inability to determine the cost drivers Treasury (SCM) reported ff challenges Challenges related to drafting of specifications No Regulations & standards; poor testing Concerns of fronting by BBBEE (Non-official suppliers)

8 Reduction Of The High Cost Of HT (HT Acquisition) Strategic Goals Development of cost reduction strategies (bulk buying discounts, restructuring of the procurement process) Strategic sourcing partnerships Develop local manufacturing capability (DTI,ED, DST,WHO) (Nurture HT industry through local acquisition) Develop a mutually beneficial HT industry Analysis of HT pricing issues Critical Success Factors Principle decision on Standardization (cost reduction, training) Mandatory participation on a national tender (Transversal-Tender Treasury) Creation of HT budget item in SC Accounting System (HT cost, improved HT asset management)

9 Ensure Safety and Efficacy of HT (HT Management) Poor maintenance practice Low maintenance rates vs high purchase rates Maintenance budgets are set at very low levels. High equipment downtime (+/- 25% in certain cases), Outsourcing rife but costly (8 X higher than inhouse) Low number of HT managers Deteriorating clinical engineering services Skills drain

10 GOALS Establish standards for maintenance Set and enforce training standards Build technical capacity Strengthen clinical engineering infrastructure Develop and adopt an optimal mix of inhouse and outsourced maintenance

11 Critical Success Factors Strengthen national CE infrastructure (CE workshops; Maintenance budget) Review HT Structure, activate and fill all the existing posts Skills retention to be prioritized Put stringent measures in place with serious consequences for non-compliance (e.g Aviation industry/ OHSC) Nation wide capacity building drive (MEMS, convert graduates CE)

12 Ensure Appropriate Introduction, Adoption and Continued Use Of HT (HT Assessment) Rapid rate of technological influx (fin implications) Lack of scientific basis on which to base HT decisions Lack of comprehensive HT Assessment mechanisms (risk, dumping)

13 Ensure Appropriate Introduction, Adoption and Continued Use Of HT (HT Assessment)... GOALS Development of HTA Processes Establishing relevant HT committees Foster National and International HTA collaboration Critical Success Factors Revival of the HT Committees

14 Development of Relevant Legislation (HT Regulations) Existing Hazardous Substances Act Only Electromedical and radiation emitting devices are registered New regulations all Medical Devices-SAHPRA Based on four risk classes

15 CAPACITY DEVELOPMENT HT Management posts Filling of all vacant CE posts Training (bursary schemes by accelerated programmes etc) New posts required International sourcing of skills provinces,

16 WC LP NC NW MP KZN GP FS EC CAPACITY DEVELOPMENT NUMBER OF 92TECHNICIANS current year 2000 required (norms)

17 Complexity Equipment Complexity vs Training Cost/Time A B o b a Quantity Cost or Time Complexity of equipment versus

18 THANK YOU