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The MedTech Funding Mandate (MTFM) policy was introduced in 2021 by the National Health Service (NHS) England, to facilitate the adoption of innovative, cost-saving medical technologies approved by the National Institute for Health and Care Excellence (NICE) within the NHS. This policy aligns with the objectives of the Getting It Right First Time (GIRFT) initiative, which aims to improve clinical effectiveness by reducing unwarranted variations in healthcare practices. In April 2022, the MTFM policy included four technologies for the treatment of bladder outlet obstruction (BOO). These technologies offer clinical effectiveness, resource efficiency, and affordability, as recommended by NICE. Despite the availability of NICE-approved minimally invasive surgical treatments (MISTs) for BOO, transurethral resection of the prostate (TURP) remains the commonest surgical treatment for BOO, although there is debate as to whether this remains the gold-standard of care. The inclusion of the four BOO technologies in the MTFM policy aims to address the existing inequalities in patient access to NICE-approved treatments and support the adoption of these effective alternatives to monopolar TURP. Key stakeholders, including GIRFT, Urology Area Networks (UANs), and the 15 Academic Science Networks (AHSNs), play a crucial role in implementing the MTFM policy. The policy has significant implications for clinical practice, promoting pathway transformation, resource and cost savings, and a comprehensive range of treatment options for patients with BOO. [ABSTRACT FROM AUTHOR]

Objective: To present the long‐term adjuvant radiotherapy outcomes of patients with pN3 squamous cell carcinoma of the penis (SCCp) treated at two UK centres. Patients and Methods: We conducted a retrospective audit of all pN3 SCCp patients, deemed suitable for adjuvant therapy by a specialist multidisciplinary team at St George's and Leeds Hospitals, who received adjuvant radiotherapy. Primary outcomes were recurrence‐free survival (RFS), cancer‐specific survival (CSS) and overall survival (OS). Secondary outcomes were time to adjuvant treatment, frequency of in‐field recurrence, site and side of recurrence, and dose and schedule of radiotherapy. Results: A total of 146 patients were included: 121 completed radiotherapy, 4 did not complete radiotherapy and 21 did not start it. The median (interquartile range [IQR]) age was 59 (54–70)years. The 5‐year RFS was 51%, CSS was 51% and OS was 44%. Adjuvant radiotherapy was started at a median (IQR) of 75 (48–106) days. A dose of 45 Gy in 20 fractions was most commonly used. Of the 125 patients who started adjuvant treatment, 55 relapsed. Of these relapses, 30 occurred in an inguinal or pelvic nodal station and 26 of the 30 were in a radiation field. Relapses in 18 of the 55 cases were in visceral sites only and seven were in both nodal (non‐irradiated sites) and visceral sites. Doses of <50 Gy were used more commonly before 2013 and higher doses (>50 Gy) were more commonly used after 2013. Conclusions: Application of a standard radiotherapy protocol within a centralized supra‐network setting has achieved survival outcomes that would appear better than those previously documented for either radiotherapy or chemotherapy in a cohort with solely pN3 disease. The addition of adjuvant chemotherapy may improve these outcomes further. These data suggest that adjuvant radiotherapy has a role to play in the management of men with pN3 SCCp. [ABSTRACT FROM AUTHOR]