Evaluation of the impact of a technology appraisal process in England: the South and West Development and Evaluation Committee.
OBJECTIVE
To examine the influence of the English National Health Service (NHS) South and West (S&W) region Development and Evaluation Committee (DEC) technology appraisal reports on purchasing and clinical decisions in the S&W and elsewhere in the NHS, and to estimate the cost of the DEC process.


METHODS
Two postal questionnaires examining issues of awareness, influence and quality of the DEC reports were sent to samples of clinical and managerial health service staff in S&W NHS region, the North West NHS region, and three other randomly selected health authorities elsewhere. Supplementary telephone interviews were undertaken with a subsample of staff. Trends in utilisation before and after the publication of four S&W DEC reports were examined using routine health service data.


RESULTS
Survey response rates ranged between 73% and 85%. Within health authorities in the S&W, agreement about the impact of the DEC in informing policy and purchasing decisions was consistently high, although responses from clinicians were more equivocal. In the topic areas examined, the impact of the DEC reports could not be separated from wider influences on practice. The cost of each DEC report is estimated to have been pounds sterling 24659.


CONCLUSIONS
Health service staff perceived that the S&W DEC process had had an impact on policy decisions and clinical practice locally; however, any actual impact on practice could not be identified with routine data. The approach used in this study would be valuable in evaluating the impact of the English NHS National Institute for Clinical Excellence.
Dixon
Simon
S
School of Health and Related Research, University of Sheffield, Sheffield, UK.
Coleman
Pat
P
Nicholl
Jon
J
Brennan
Alan
A
Touch
Sandra
S
D001291:Attitude of Health Personnel; D003657:Decision Making; D004107:Dilatation and Curettage; D004739:England; D019317:Evidence-Based Medicine / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007407:Interviews as Topic; D019982:Organizational Case Studies; D010034:Otitis Media with Effusion / Q000601:surgery; D011247:Pregnancy; D011295:Prenatal Care; D013222:State Medicine / Q000592:standards; D011795:Surveys and Questionnaires; D013673:Technology Assessment, Biomedical / Q000191:economics / Q000592:standards*; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control