NHS England has advised that they are in the process of examining the evidence for extending access to transcatheter aortic valve implantation (TAVI).
In June 2016 it hosted a Clinical Summit to examine the issues relating to aortic valve disease. This reviewed the growth in the use of TAVI, and possible reasons for variation in use.
The outcomes from this summit are now part of the work plan for the Cardiac Services Clinical Reference Group and are being considered within the scope of the specialised cardiac review in 2017/18 . This review will include an analysis of current clinical commissioning policy, the evidence base, and the cost-effectiveness of different interventions; and will inform future commissioning position.
The reasons for the increase in demand and variation are multifactorial, and for this reason, a review of the wider aortic stenosis pathway is the most appropriate approach. The review will include the medical therapy and traditional surgical pathway and will also include specialised centres, secondary care and primary care clinicians.
The review is currently in its scoping phase. The timescales, format and the duration of the associated consultation will be dependent on the agreed scope of the review, which is expected to be finalised in summer 2017. The timelines for reviewing TAVI will be confirmed in line with the timelines for the cardiac review and high cost devices programme.
The approach to phase two of the commissioning of high cost devices is still being finalised but is expected to include engagement with stakeholders from patient groups, industry and industry bodies.