Health Technology Assessment

Scope

Our HTA Programme funds health and social care research with outcomes that are immediately useful to patients, social care users, clinical or social care practice, or to NHS or social care policy or decision makers.

HTA research is undertaken when evidence already exists to show that a technology can be effective. The purpose of HTA research is to establish the clinical and cost-effectiveness of the intervention for the NHS or social care, in comparison with the current best alternative(s).

What are technologies?

'Technologies’ in the context of HTA, means any health or social care intervention used to promote health and development, prevent, diagnose, or treat disease, or improve rehabilitation, quality of life, or long-term care. 

Examples include:

• procedures
• safeguarding interventions
• social work interventions
• therapeutic drugs
• devices
• talking therapies
• diagnostic tests
• settings of care
• screening programmes

HTA research asks important questions about these technologies or interventions, such as:

• when is counselling better than drug treatment for depression?
• what is the most cost-effective operation for aortic aneurysms?
• should aspirin be used for the primary prevention of cardiovascular disease?
• is it cost-effective to screen for lung cancer?
• do independent living programmes improve outcomes for care leavers?
• what parenting interventions best help adults with intellectual disabilities to parent successfully?

HTA-funded studies answer these questions by investigating 4 main factors:

• whether the technology works
• for whom
• at what cost
• how it compares with the alternatives

Which programme should I apply to?

See UK Research and Innovation’s guidance on identifying schemes for clinical trials. It compares the remits of NIHR and Medical Research Council translational research programmes, to help researchers determine which funding scheme is the most appropriate for their proposed project.

What we fund

We offer two types of funding opportunities:

• commissioned workstream - invites applications in response to calls for a wide range of research on specific health or social care questions. These questions have been identified and prioritised for their importance to the wider NHS, social care, or those who use these services
• researcher-led workstream - enables researchers to submit proposals for evidence synthesis or primary research on topics or research questions within the remit of the HTA Programme

Primary research is undertaken where robust evidence already exists to show that a technology can be effective, but this needs to be compared to the current standard intervention to see which works best or is most cost-effective. 

A ‘readiness check’ is carried out as part of a review of the remit and competitiveness of researcher-led applications. 

The HTA Programme will support

• evidence synthesis including systematic reviews, modelling studies and meta-analyses
• randomised controlled trials (blinded and unblinded)
• non-randomised trials, where appropriate
• network meta-analysis and expected Value of Information studies
• cohort studies (retrospective or prospective)
• complex and innovative trials including adaptive designs and platform studies
• modelling studies and health economic models
• international studies

Remit

To be within remit for the HTA researcher-led workstream:

• the primary outcome of a study should be a health- or social care-related outcome. It must also have the potential to directly benefit the wider NHS, social care, or those who use these services
• applications for primary research must be within the scope of the Programme and provide robust evidence for the importance and the efficacy or effectiveness of the intervention(s)
  • robust evidence is evidence published in a peer reviewed journal demonstrating the efficacy or effectiveness of the intervention and reporting clinically important findings based on point estimates and associated confidence intervals
  • feasibility studies showing the acceptability of the intervention or the ability to recruit participants do not alone constitute evidence of efficacy
  • on rare occasions, new primary research may be required urgently. Applicants will need to convince HTA of the urgency of the research and if accepted, we may accept unpublished findings supported by datasets that allow the analysis to be replicated
• if robust peer reviewed evidence of efficacy or effectiveness has not been published, HTA may accept evidence that the intervention is widely used in, or is available to, the NHS or social care and is likely to diffuse into widespread practice

We will screen all researcher-led applications to ensure they are in remit. Applications that are not in remit will not be considered by a Funding Committee. 

Competitiveness

A competitive application will need:

• to bring together a diverse multi-professional team with strong expertise and a track record of research, including clinicians/practitioners, methodologists, and health economists as well as patient and public representatives
• to include or cite an up-to-date systematic review of existing literature to determine whether further research is needed
• to offer value for money, with costs which are reasonable and proportionate to the potential impact on patients, health, or care services
• to have an efficient, scientifically robust and carefully justified approach (the Programme is not prescriptive about study design)
• to ensure that any surrogate outcomes have convincing evidence linking them to the specified health outcomes, e.g. HbA1c for diabetes outcomes, improved child and adolescent behaviour for longer term mental health and wellbeing. Without convincing evidence they are rarely accepted as a primary outcome
• any social care intermediate outcomes to be robustly measured, using core outcome sets when available
• participation and study locations to be inclusive in every sense, to ensure results are generalisable
• the duration of a study to be appropriate and sufficient to allow the research to be conducted to a high standard, and for recruitment rates to be realistic and justified
• applicants to explain and justify the importance of the research issue for the NHS or social care
• mentoring arrangements to be in place for less experienced lead applicants

The HTA Programme will not support

• hypothesis testing, proof of concept studies or research for ‘newly developed’ or ‘adapted’ interventions without existing proof of efficacy
• phase 2 trials (our EME Programme may be more suitable)
• assessing the provision of information or the effect of educational interventions on an individual’s knowledge or behaviour, unless directly linked to a discrete health outcome
• research on new equipment
• PhD research or fellowship projects
• standalone pilot or feasibility studies unless requested within a commissioning brief

See the success rates for HTA proposals

Our people

In this section you can read more about the people involved in assessing applications.

New developments are transforming the ways in which research in the NHS and social care landscape is organised and carried out. Our HTA Programme invites and works with a range of people to meet the research needs of the NHS and social care. Their support and input allows us to fund high-quality, evidence-based, value-for-money research.

The people who work in, work with, or use NHS and social care services provide vital input into all stages of research funded through the HTA Programme.

Our Director

Professor Andrew Farmer

Our committees

HTA committees meet 3 times each year. They:

• consider commissioned calls for research
• assess the scientific merit of proposals submitted to both the commissioned and researcher-led workstreams
• make funding recommendations to the Programme Oversight Committee

Read more about our committee membership:

• HTA Funding Committee (General)
• HTA Funding Committee (Commissioning)
• HTA Funding Committee Clinical Evaluation and Trials
• HTA Prioritisation Committee: Primary and Community Based Care
• HTA Prioritisation Committee: Hospital Based Care
• HTA Prioritisation Committee: Social Care
• HTA Programme Oversight Committee Funding Committee minutes and outcomes

All our committee members must declare any conflicts of interest when reviewing applications, and complete our Register of Interest form (annually).

Reviewers

To assure the scientific quality of its research, the HTA Programme relies upon the help of external reviewers to review:

• the research and commissioning briefs it produces
• the research proposals it receives
• the final reports of research findings

External reviewers play a vital part in maintaining and improving the quality of our research. We involve people from a variety of fields who bring a range of knowledge and experience. This includes clinicians, methodologists, and those who work in and use health and social care services. We are grateful for all the important work our external reviewers do, and have listed the past year’s reviewers. Find out more about becoming a reviewer or committee member.

Applying

Fast-track scheme

Most research supported by our HTA Programme will follow a 2-stage application and assessment process before being funded. That is, a Stage 1 proposal will first be assessed by a Funding Committee. Shortlisted applications are then invited to submit a Stage 2 proposal for further assessment by a Funding Committee. However, it may sometimes be necessary to accelerate the handling of a topic and in such circumstances researchers may be eligible to apply through the fast-track scheme. Please note that this scheme is not open to HTA commissioned calls.

The fast-track scheme provides an opportunity to submit a Stage 2 proposal directly, shortening the length of time it takes for a funding decision to be made. However, please bear in mind that proposals accepted onto the fast-track scheme will be considered on equal terms with other Stage 2 proposals which have had the benefit of feedback by the Funding Committee at Stage 1.

If you would like your proposal to be considered for the fast-track scheme, please contact htacet@nihr.ac.uk. You will be asked to:

• convince the secretariat that there is significant benefit to the NHS or social care of fast-tracking your application
• submit a written summary of your proposal (usually about one side of A4) in a PICO format if appropriate and/or describe the study briefly in terms of aims, research questions, outcome measures, scale, patient and public involvement, inclusion, stakeholder engagement, outputs, and dissemination

We will then consider the information you provide, and will let you know whether your proposal is eligible for fast-tracking. If it is, we will send you more information about submitting your Stage 2 application, and the timescales for doing this.

Application support

Do you need help getting started? Contact the Research Support Service.

Do you need assistance running your study in the NHS? Contact the Study Support Service.

Contact us

We offer a wide variety of assistance during all stages of the research process. If in doubt, please get in touch.

For help with applying for HTA funding, you can email htafunding@nihr.ac.uk or phone 023 8059 5544.

To enquire by email about a commissioned funding opportunity, please contact htacommissioning@nihr.ac.uk 

To enquire by email about a researcher led funding opportunity, please email htacet@nihr.ac.uk