International Journal of Technology Assessment in Health Care

General Essays

Assessing the impact of England's National Health Service R&D Health Technology Assessment program using the “payback” approach

James Rafterya1, Stephen Hanneya2, Colin Greena3 and Martin Buxtona4

a1 University of Southampton

a2 Brunel University

a3 University of Exeter

a4 Brunel University


Objectives: This study assesses the impact of the English National Health Service (NHS) Health Technology Assessment (HTA) program using the “payback” framework.

Methods: A survey of lead investigators of all research projects funded by the HTA program 1993–2003 supplemented by more detailed case studies of sixteen projects.

Results: Of 204 eligible projects, replies were received from 133 or 65 percent. The mean number of peer-reviewed publications per project was 2.9. Seventy-three percent of projects claimed to have had had an impact on policy and 42 percent on behavior. Technology Assessment Reports for the National Institute for Health and Clinical Excellence (NICE) had fewer than average publications but greater impact on policy. Half of all projects went on to secure further funding. The case studies confirmed the survey findings and indicated factors associated with impact.

Conclusions: The HTA program performed relatively well in terms of “payback.” Facilitating factors included the program's emphasis on topics that matter to the NHS, rigorous methods and the existence of “policy customers” such as NICE.



Thanks to the Advisory Group, chaired by Mr. Chris Henshall, Pro Vice Chancellor, York University comprising: Professor Philip Home, Professor of Diabetic Medicine, University of Newcastle; Ms Lynn Kerridge, Chief Executive Office NCCHTA, Dr Kalipso Chaldikou, NICE, Mr. Peter Sneddon, Head of Research Programs, Department of Health. Dr Isobel Walter, Senior Research Fellow, School of Management, University of St. Andrews. The group met on August 2005 and February 2006 to provide advice on choice of method, on the progress of the survey and the weighted sampling of the case studies. Members of the group also commented on the first draft of the report. They bear no responsibility for the final draft. The contribution of those who responded to the survey and those who agreed to be interviewed is also acknowledged.