Question to the Department of Health and Social Care:

To ask His Majesty's Government what consideration they have given to reviewing the national commissioning model for high cost, high impact medical devices.

The NHS Payment Scheme (NHSPS) and the National Commissioning model for high cost, high impact medical devices look to review the appropriate commissioning model for such devices. They ensure patients can access clinically effective high-cost devices, while maintaining consistency across England and ensuring the responsible use of public funds. They are kept under constant review to ensure it reflects clinical evidence, innovation, and National Health Service priorities.

Where devices are particularly high cost, clinically specialised, or used only for defined patient groups, they may be excluded from the national tariff. High-cost device exclusions are kept under regular review by NHS England as part of the annual NHSPS development process. Where a device becomes more routinely used, its cost reduces, or it can reasonably be absorbed into standard prices, NHS England may consider removing the exclusion and bundling the device into the national tariff. Conversely, exclusions may be introduced where new technologies are high cost, used for limited patient cohorts, or present material financial risk. Any proposed changes are consulted on publicly and confirmed through publication of the NHSPS.

Some high-cost devices are also subject to NHS England’s Specialised Services Devices Programme. This applies to devices used in specialised services that are commissioned nationally, often for patients with complex or rare conditions. The programme provides a structured process to assess clinical effectiveness, patient benefit, affordability, and system impact before devices are routinely commissioned. Where approved, NHS England may introduce national commissioning policies, central procurement arrangements, or national pricing agreements, with funding aligned to specialised commissioning while operating alongside the NHSPS.

For devices not covered by either national prices or exclusions, the NHSPS allows local pricing agreements, provided these adhere to national pricing rules and principles on efficiency, transparency, and value for money.