NICE CEO Calls for Digital Health Funding Reform
This week, NICE CEO Dr Sam Roberts made headlines with her call to overhaul how the NHS purchases digital health technologies, arguing they should be paid for "like medicines" through central reimbursement. Her comments highlight a fundamental challenge in digital health adoption that deserves our attention.
A Tale of Two Standards
Roberts has identified a striking inconsistency in NHS purchasing. While patients have a legal right to receive NICE-approved medicines, no such mandate exists for digital tools and services that have passed the same rigorous cost-effectiveness assessments. This creates what she calls "inequalities of provision" where NHS organisations do not need to offer access to NICE-approved digital innovations.
The scale of this issue is growing rapidly - NICE is now conducting 30 times more digital appraisals than just two years ago, reflecting the accelerating pace of health tech innovation.
Assessing the Proposals
Roberts' central reimbursement model would certainly drive adoption, but unlike drugs, digital tools often require substantial infrastructure changes, deployment support and ongoing technical support that complicate funding models. Her proposal for NICE to "lead the charge" in identifying priority areas makes sense given their expertise, though questions remain about capacity and scope.
What's Happening Today
The current situation is complex which is part of the problem. NHS England currently performs some of these functions, but much more narrowly than Roberts envisages. The existing MedTech Funding Mandate only covers technologies demonstrating cost savings within three years and budget impact under £20 million - a small subset of approved digital tools.
The Government pledged over £2 billion for NHS technology and digital in its October 2024 Autumn Budget. This is for project-based investment rather than the systematic reimbursement model Roberts proposes.
Crucially, the government's March 2025 announcement that NHS England will be abolished casts significant uncertainty over the direction of travel. Digital health leaders worry this reorganisation could delay or derail the shift from analogue to digital.
Key Challenges Ahead
Beyond funding, several critical issues need addressing. What constitutes a "digital health technology" requiring NICE evaluation - should this include simple referral tools alongside complex AI algorithms? NICE's historical focus on higher-cost interventions could create a bias in digital health unless better demand signalling identifies NHS priorities.
International examples from Germany and France demonstrate that systematic digital health reimbursement is feasible and can improve access while supporting evidence-based adoption. The broader principle -funding effective interventions regardless of whether they're pharmaceutical, surgical, or digital - represents a shift toward more patient-centred decision making.
Looking Forward
Roberts' vision of England as a distinctive life sciences destination is compelling, but realising this potential requires addressing funding mechanisms alongside broader ecosystem challenges. As the government develops its 10-Year Health Plan amid major structural reorganisation, these conversations about digital health procurement are both timely and necessary.