The Rapid Review Panel

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The Rapid Review Panel

• Chris Gush

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Rapid Review Panel

• Chief Medical Officer. Winning Ways Working
  together to reduce Healthcare Associated
  Infection in England. Report from the Chief
  Medical Officer. London Department of Health,
  December 2003.
• Department of Health. Towards cleaner hospitals
  and lower rates of infection A summary of
  action. London Department of Health, July 2004
• First meeting of the Rapid Review Panel, August
  2004

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Remit

• To provide a prompt assessment of new and novel
  equipment, materials and other products or
  protocols that may be of value to the NHS in
  improving hospital infection control and reducing
  hospital acquired infections

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The Panel
Microbiology Consultants Disinfection and
Pharmacology expert scientists
Infection Control Doctors Aerobiology
scientific expert Infection Control Nurses
Observers PASA, DH
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Process 1

• Companies contact DH
• Application form with guidance sent for
  completion
• Legal sign up required
• Submitted forms reviewed and lead panel member
  assigned
• Meeting set
• Copies of all applications sent to panel members

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Process 2

• The Panel meets
• Report and recommendation produced for each
  product
• Reports released to companies 24 hours prior to
  publication
• Publication

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RRP Application Form

• 1. Contact details
• 2. Product/process name and date of release
• 3. Where else is it marketed?

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RRP Application Form

• 4. How will it contribute to reducing HCAIs?
• 5. What is innovative/new?
• 6. Mechanism of action

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RRP Application Form

• 7. In vitro activity
• 8. Evidence of impact on HCAIs
• 9. Why is this product more effective than
  similar products?

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RRP Application Form

• 10. Information to ensure assessment of risk and
  activity
• 11. References
• 12. Authorisation

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Recommendations

• 1. Basic research and development, validation and
  recent in use evaluations have shown benefits
  that should be available to NHS bodies to include
  as appropriate in their cleaning, hygiene or
  infection control protocols. (3)
• 2. Basic research and development has been
  completed and the product may have potential
  value in use evaluations/trials are now needed
  in an NHS clinical setting. (19)

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Recommendations

• 3. A potentially useful new concept but
  insufficiently validated more research and
  development is required before it is ready for
  evaluation in practice. (40)
• 4a. Not a significant improvement on
  equipment/materials/products already available
  which claim to contribute to reducing health care
  associated infection no further consideration
  needed. (35)

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Recommendations

• 4b. Unlikely to contribute to the reduction of
  health care associated infection no further
  consideration needed.
• 5. Insufficient clarity/evidence presented to
  enable full review of the product. (47)

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Recommendations

• 6. An already well established product that does
  not merit further consideration by the Panel.
  (17)
• 7. The product is not sufficiently related to
  infection control procedures to merit
  consideration by the Panel. (7)

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Products reviewed to date

• 172 reports issued
• 10 products reviewed at the end of March
• 20 applications received for late Spring

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Distribution of recommendations
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Types of product reviewed

• Cleaning Products/Disinfectants
• Surface coatings
• Air decontamination
• Fabrics
• Hand cleansing
• Other
• Outside remit

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Distribution of applications
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The Rapid Review Panel is only the first step in
the process
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NHS Implementation
PASA / Inspector of Microbiology
Centre for Evidence-based Purchasing
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Advice to the Department of Health
1,2
3,5
Recommendation 1,2,3,4,5,6,7 Rapid Review
Panel Submission
Applicant
MHRA
PRODUCT / PROCESS
Carriage eradication products
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• It is not within the remit of the RRP to
  clinically evaluate or undertake the evaluation
  of products within the NHS.
• It is for the manufacturer to initiate and
  complete such trials/evaluations.
• Furthermore it is not within the remit of the
  panel to influence procurement and the uptake
  of products into the NHS once recommendations are
  formulated.

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• The RRP is an independent arms-length review
  panel that does not have a role in the
  procurement of products in the NHS and does not
  champion specific products once evaluated.

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Recommendation Category 1

• Bardex 1C silver alloy hydrogel catheter
• Introduced into NHS logistics stock 9/05
• Chloraprep topical antiseptic
• Licensed and in consolation with NHS Supply
  Chain
• Dermamed skin protectant
• Information being sought by PASA

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• We find it surprising that the RRP has
  identified silver-coated alloy catheters as
  useful.
• The battle against HCAI should be fought with
  the golden weapons of evidence-based conclusions,
  rather than hasty silver recommendations
• J. Hosp. Infect. 60 381 (2005)

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Recommendation Category 2

• Hand/skin care (x5)
• Air purification (x3) and decontamination (x2)
• MRSA nasal carriage screen (x1)
• Disinfectant (x2)
• Other (x5)

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Separating
Myth
Reality
From
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• The RRP . is considering making use of the
  varnish . We have started talking to the RRP and
  we are making very good progress

Local Press Dec 2004
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• A further recent ground breaking technology was
  XXXXXX, which became the first cleaning system to
  be approved for use by the Governments Rapid
  Review Programme Industrial safety talk July
  2005

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• I learned that, of the (miserable) 3M set aside
  for MRSA research by John Reid, the Panel has
  itself gone through 1.5M. Correspondence April
  2005

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• I confirm that the company is the manufacturer
  of the product or has been authorised by the
  manufacturer to sign this disclaimer.

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Endorsement exclusion

• Subject to the right to quote the opinion of the
  RRP in its marketing material, the company shall
  not use the evaluation as an endorsement or
  recommendation of the product.

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Highest Impact Intervention Is

• GOOD INFECTION CONTROL PRACTICE

• Hand hygiene
• Personal protective equipment
• Aseptic technique

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For further information
www.hpa.org.uk/infections/topics_az/rapid_review/d
efault.htm