Recommendation 23

NHSE described how it has established an evidence base for which specialised products are best to use (formerly known as high cost tariff excluded devices and now known as the Specialised Services Devices Programme). NHSE explained in written evidence that products purchased through this route are effectively free to trusts, with any consequent savings being available for spending elsewhere in the NHS. The resulting financial incentive for the trust is to purchase the ‘free’ device, creating the potentially perverse incentive of local financial incentives being in tension with local clinical preference or clinical judgement and not therefore always in the best interests of patients.40