Presentation (CTI)

OBJECTIVES: Equality in health technology assessment is fundamental to ensure fair and equitable access to healthcare for all individuals, regardless of their characteristics or background. The National Institute for Health and Care Excellence (NICE) is England’s health technology assessment agency. NICE’s HealthTech programme produces guidance on non-drug technologies, including medical devices, digital and diagnostic technologies, and interventional procedures. All NICE guidance includes an equality impact assessment. This research explores trends in equality considerations and their impact on recommendations in HealthTech guidance.
METHODS: All HealthTech guidance published between April 2024 and March 2025 was reviewed, including equality impact assessments. Data on equality considerations was extracted and coded using the following categories: age, disability, gender reassignment, pregnancy/maternity, race, religion/belief, sex, sexual orientation, socioeconomic inequality, health inequality, and other. It was also recorded whether any of these equality considerations impacted on the recommendations.
RESULTS: Twenty-nine pieces of HealthTech guidance were included. Of these, 18 were on interventional procedures, 6 on digital technologies (including AI), 2 on medical technologies, and 2 on diagnostic technologies. All but 1 guidance included multiple equality considerations. The most common equality considerations included age and disability, reported in 25 and 23 guidance topics, respectively. These were followed by sex (n=18), race (n=16), other considerations (n=14), socioeconomic inequalities (n=10), health inequalities (n=5), religion/belief (n=4), gender reassignment and pregnancy/maternity (n=2 each) and sexual orientation (n=1). For interventional procedures guidance, none of the equality considerations impacted on the recommendations. For the other 11 HealthTech guidance products, 7 guidance recommendations were adjusted for multiple equality considerations including ‘other’ (n=6), race (n=3), age and disability (n=2 each), and sex and socioeconomic inequalities (n=1 each).
CONCLUSIONS: Equality impact assessments are essential to producing HealthTech guidance to ensure fair and equitable access to healthcare. All guidance reported equality considerations, however, these affected recommendations in approximately 25% only.