What were we asked to look at
Healthcare Improvement Scotland (HIS) have been asked to evaluate the clinical and cost-effectiveness of adding the use of disposable (single use) biopsy equipment in an outpatient setting to the diagnostic pathway of suspicious laryngeal/pharyngeal lesions in NHSScotland. In addition, SHTG has agreed to update its assessment on outpatient biopsy equipment, conducted in 2018.
Why is this important
With the growing incidence of head and neck cancer and the pressures to the healthcare system as a result of the Covid-19 pandemic, there has been an increasing difficulty achieving the Scottish Government targets on waiting times for diagnosis and treatment. The available options for diagnostic care - inpatient panendoscopy (requiring theatre time) and outpatient biopsy procedures with re-usable equipment (aerosol producing) - may be insufficient to address the current challenges. Disposable biopsy equipment as on option may help resolve some of these issues. In a post-pandemic world, however, the possibility of obtaining a tissue sample in a dedicated clinic room in an outpatient setting may result in avoided inpatient procedures under general anesthetic as indicated in the SHTG assessment from 2018. Nevertheless, uptake of this technology has not met expectations, possibly due to the cost of initial investment and uncertainty around diagnostic accuracy at the time.
Consultant ENT Surgeon, NHS GG&C