title: A rapid needs assessment of the provision of Health Technology Assessment in the south-west peninsula.
abstract: BACKGROUND
  Key to delivering UK policies on clinical governance, evidence-based practice and value for money is Health Technology Assessment (HTA). Despite the provision of HTAs through the National Institute for Health and Clinical Excellence (NICE), local health organizations still undertake HTA and make decisions based on them. In some regions, capacity is provided by centralized arrangements, but in others provision is ad hoc. This rapid needs assessment evaluates the provision of HTA in the south-west peninsula, and its scope, content and quality.
  
  
  METHODS
  We used semi-structured interviews and documentary analysis to assess the need for HTA.
  
  
  RESULTS
  HTAs are most commonly used by drug and therapeutics committees and joint formulary committees. The scope of technologies assessed was predominantly drugs. The quality of literature review in HTAs was variable and virtually none considered value for money. Informants felt there was insufficient provision of local HTAs. Local focus and clinical engagement were seen as key to the implementation of appraisal decisions, but this was threatened by weak links with commissioning and processes to prioritize decisions across primary care trusts.
  
  
  CONCLUSIONS
  The quality of some HTAs poses a risk to clinical and corporate governance.
authors.affiliation: Institute of Health and Social Care, Peninsula Medical School, Barrack Road, Exeter EX2 5DW, UK. julian.elston@nhs.net
authors.forename: Julian
authors.initials: J
authors.lastname: Elston
authors.forename: Ken
authors.initials: K
authors.lastname: Stein
mesh_terms: D020811:Biomedical Technology / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D003657:Decision Making; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D020380:Needs Assessment / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D006113:United Kingdom