Victorian Policy Advisory Committee on Clinical Practice and Technology

Terms of Reference

Background

The Victorian Department of Human Services (department) established the Victorian Policy Advisory Committee on Clinical Practice and Technology (VPACT) to consider and make recommendations regarding the application of new and existing technologies and clinical practices in Victorian public health services and hospitals.  This includes identifying, prioritising, introducing, evaluating and ongoing monitoring of new and existing technologies and clinical practices. 

1. The Australian Government established the Health Policy Advisory Committee on Technology (HealthPACT), comprising jurisdictional representation, to advise the Australian Health Ministers’ Advisory Committee and the Medical Services Advisory Committee (MSAC) on the introduction of new and emerging technology into the Australian health care system.  
   
   
2. HealthPACT has oversight of the Horizon Scanning Unit (HSU), whose role is to identify and undertake assessments of new and emerging technologies.  The Australian Safety and Efficacy Register of New Interventional Procedures – Surgical (ASERNIPS), a programme of the Royal Australasian College of Surgeons, and NET-S contribute to this process.  
   
   
3. The activities of VPACT will complement and supplement those being undertaken by HealthPACT.  It will address Victorian specific issues and utilise HealthPACT information where available.  From time to time, VPACT may also sponsor work on behalf of HealthPACT.  VPACT will also consider good practice management of medical and surgical supplies regarding the use of new or existing technologies or clinical practices.  

The scope of technology and clinical practice to be considered comprises all types of clinical diagnostic or treatment interventions including prostheses, implantable devices, diagnostic tests, medical and surgical procedures and high-cost pharmaceuticals.  The Victorian Medicines Advisory Committee is being established to specifically consider other pharmaceuticals as well as the quality use of medicines and they may, from time to time, seek advice from VPACT.

Role and Function

VPACT has been established to enable a systematic approach to the introduction and use of new and existing technologies and clinical practices in public health services in Victoria. Its role is to advise and make recommendations on:

• Mechanisms for early identification of new technologies and clinical practices with potential implications for public health services
• Assessment of clinical and cost effectiveness of new and existing technologies and clinical practices
• Establishment of Nationally Funded Centre Applications
• Priorities for the introduction and use of new technologies and clinical practices
• Policies and procedures for best practice for introduction and use of new and existing technologies and clinical practices in public health services
• Policies about new or modified health service delivery as required by introduction of new or changed technology
• Requirements for evaluating and monitoring the introduction and use of new technologies and clinical practices in public health services
• Dissemination of information on the introduction and use of new and existing technologies and clinical practices.

VPACT will also liaise with the following:

• Victorian Medicines Advisory Committee (VMAC)
• Established committees in Victorian health services that consider the assessment and adoption of new technologies and clinical practices within their institutions
• HealthPACT and MSAC on the introduction of new and emerging technology in the Australian health care system
• The National Institute for Clinical Studies
• Established committees in other jurisdictions providing advice on introducing new technology and clinical practice
• Other Health Technology Assessment agencies nationally and internationally, such as Health Technology Assessment international (HTAi) and International Network of Agencies for Health Technology Assessment (INAHTA).

VPACT members will:

• Disclose any actual or potential conflicts of interest, and for complying with the identified method of addressing any such conflicts
• Ensure that any information acquired or created as part of this Project is only used for performing duties as a VPACT member.

The principles underpinning the deliberations and recommendations of VPACT are:

• Health and safety for patients, clinicians and the community is paramount.
• Broad-based stakeholder consultation is considered.
• Ethics procedures are in place to protect patients, clinicians and the community.
• Appropriate institutional committees approve technology for use.
• Evidence-based practice informs conditions and logistics for introduction.
• Patient information and informed consent procedures are established.
• Appropriate and credentialed and trained staff in place to assist with new technology introduction.
• Risk management procedures are in place to reduce adverse events.
• There is no conflict of interest between a provider and technology supplier.

Membership

VPACT will provide information, advice and knowledge to assist with the introduction and use of new and existing technologies and clinical practices in the public sector.  Ideally, it will encompass knowledge and expertise about:

• Health technology assessment
• Health service delivery
• Health policy
• Quality and safety
• Evidence-based review and clinical practice
• Population health
• Health economics
• Clinical pharmacology
• Clinical medicine
• Consumer advocate/s
• Senior health service management. 

Membership will also include representation from a public health service Technology/Clinical Practice Committee.

The term of appointment of the chair and members will be for two years in the first instance, except for the senior health service manager, who will rotate annually, and the Senior Medical Advisor, Programs Branch.  Members who do not attend at least three meetings per annum will automatically lose their membership unless extenuating circumstances can be proven.  Substitution of appointed members will not be permitted.  Members will be appointed for a maximum of two two-year terms.

Conflict of interest and confidentiality

VPACT members must ensure that any real or potential conflict of interest arising in regard to any matter under discussion by VPACT is made known at the commencement of each VPACT meeting, particularly when considering submissions from health services/hospitals where members practise.  Where discussion ensues on a matter in which the VPACT member has declared a real or potential conflict of interest, the VPACT member will comply with the identified method of addressing any such conflicts, which requires him/her to absent himself/herself from participation in that discussion. 

VPACT members must ensure that any information acquired or created for VPACT consideration is only used for performing duties as a VPACT member.  Members may not use their knowledge of confidential VPACT issues to provide inequitable benefit gain or advantage to any individual, private or public organisation or group.

Meetings

VPACT will meet up to four times per annum depending on the number and scope of issues and initiatives being addressed.  Clinical experts may be invited to attend VPACT meetings and contribute to its activities.  Decisions of VPACT will be made by consensus.  If consensus is not possible, a majority will suffice.  For a decision or recommendation, a quorum will comprise half of all VPACT members plus one.

Applicants making submission to VPACT are not to canvas VPACT members and would not routinely be invited to present to VPACT.

Challenge of VPACT recommendations

Applicants who wish to challenge a VPACT recommendation should present their case in writing within 60 days of receiving written notification of the decision.  A challenge should be endorsed by the Chief Executive Officers of all health services/hospitals that participated in the submission to VPACT.  The department will seek to clarify the issues; actions may include seeking further independent expertise and, if appropriate, further review by VPACT.

Reporting/notification of VPACT recommendations

After VPACT makes its recommendations, departmental endorsement of the recommendations is sought through the Executive Director, Metropolitan Health and Aged Care Service.  Following endorsement, the department will contact the lead applicant and arrange a meeting to consider costs, monitoring requirements, reporting requirements and a plan for implementing the new technology/clinical practice. 

Operations

Time-limited panels may be formed to oversight particular projects or assemble advice on a specific issue.  Such panels: will be chaired by a VPACT member, may coopt independent members, may seek other expert opinion in pursuit of information and will report to VPACT.  External consultants may be contracted by the department to undertake a review of new technology/clinical practice to inform VPACT consideration.  VPACT will oversight this process.

Secretariat

Programs Branch, Metropolitan Health and Aged Care Services Division, Department of Human Services, will provide secretariat support for VPACT.

Enquiries / Contact

Enquiries can be directed to Dr Paul Fennessy, Senior Policy Officer, on 03 9096 2142 or email paul.fennessy@dhs.vic.gov.au