LAAO in England - Arrhythmia Alliance Group

AF Information & Advice For Patients

Timelines for Commissioning LAAO in England

2012	A draft policy statement was issued by the Specialised National Commissioning Board (SNBC) to restrict the commissioning of a very important therapy for people unable to take oral anticoagulation - Left Atrial Appendage Occlusion (LAAO).
2013	In February, we asked for your support to campaign against this decision. Following the high number of responses from patients, carers and healthcare professionals to their MP's and service providers, we were reassured by the SNBC that all responses received were included in the review of this statement.
2013	In April, NHS England published a clinical policy statement on LAAO that states the procedure will not be routinely funded, but will be assessed further through a ‘commissioning through evaluation’ process.
2014	A limited funding was granted for 450 patients to be performed in 10 selected centres alongside data collection funded by NHS England in a process called Commissioning through Evaluation
2016	Recruitment of 450 patients was completed. No further funding was available for LAAO procedures in England once this recruitment phase was complete.
2017	NICE started a review of the Commissioning through Evaluation evidence and developed an economic analysis. At the same time, NHS England commissioned a parallel review as part of the policy prioritisation process (PPP).
2018	Both reviews have now concluded and are under consultation (which closed on 1st April 2018). The proposal is to fund LAAO routinely for a specific patient population. This includes patients with non-valvular Atrial Fibrillation with a high thromboembolic risk (CHA2DS2-VASC score of 2 or greater) and with physician-assessed contraindications to Oral Anti-Coagulants (both VKAs and NOACs)
May 2018	Once the consultation process has completed, the Clinical Products Advisory Group will meet, and decide on the next steps. Once this has happened, we will be in a better position to advise patients on the likely timelines of funding availability to allow patients which meet the criteria outlined above, to be able to go ahead with the LAAO procedure in certain designated centres around England, likely to be those who took part in the CtE process, and maybe a few others.