12.1

When starting an HB-HTA unit, the lack of skills and resources could make it difficult to produce good quality HB-HTA reports.

Look into your hospital human resources and identify who can help you to cover the different areas of HTA (clinical, economic, etc.):

• if you do not have a skilled scientific information specialist, try to liaise with a medical library and ask for help on searching for evidence;
• if you do not have a skilled health economist, try to reach economists working in different departments in your hospital to help you with the economic part of the HB-HTA report.

12.2

The exact skills and profiles needed for an HB-HTA unit are unclear when starting.

• Ask other HB-HTA units that you know to share with you what skills and profiles their unit embraces.
• Ask for job vacancy advertisements that other HB-HTA units are using for hiring their staff.

12.3

The right skills and expertise for each task are sometimes lacking.

Cooperate with staff from other institutions (hospital-controlling, social health insurance companies, national drugs and devices approval agency) and share training sessions on methodology, etc.

12.4

It is not known what opportunities for staff training exist.

• Get in touch with universities which provide training in health economics, public health, research methods etc. and look for suitable training sessions/courses.
• Do the same with international and national societies acting in the field of HTA (HTAi, INAHTA, EUnetHTA, Cochrane Collaboration etc.)
• Look for online (free) courses, webinars, and scientific conferences to improve your staff’s skills.

13.1

The HB-HTA unit’s resources and facilities are insufficient.

When setting up your HB-HTA unit, clearly communicate to the hospital management (CEO/CMO) what specific facilities you need to run the unit.

Anticipate the need for resources such as access to databases with full-text articles for producing HB-HTA reports.

Anticipate that your needs will increase with time (e.g. hiring new staff, exchange of staff with other HB-HTA units, receiving staff for short-term visits etc), as your unit matures.

Communicate the impact of completed tasks on the hospital budget. Make “business cases” of successful HB-HTA units and use them to support your request for resources.

13.2

Financial resources are still problematic.

• Consider participating in an internship/traineeship programme (among health economics or public health students), for support duties.
• Seek funding for the collection of additional evidence on HTs introduced by contacting the manufacturer of the HT. Industry may be keen to fund the follow-up as they are interested in collecting real-world evidence (RWE) on the performance of HTs in an environment other than clinical studies (in this case conflicts of interest and explicit functioning have to be stated from the very beginning).
• Different clinical departments at hospitals often receive financial resources from third parties (industry, public bodies) for running certain projects. As these projects may be related to the activities of your HB-HTA unit, establish an agreement with the clinical departments by which in exchange for helping in carrying out or collaborating with the work to be done, they will share financial resources with your HB-HTA unit.

13.3

The funding of activities outside the organisation, such as participation in conferences, is problematic.

Provide Information in a transparent manner about the performance of your HB-HTA unit. Give a clear indication of its value, which is not only administrative, but also strategic and scientific.

13.4

Too many external projects (EU-projects, research mandates, etc.) force the HB-HTA unit to grow too fast.

Try not to grow too fast and manage the third-party projects with “internal” staff rather than hiring and firing (train and let go) external staff.

13.5

The HB-HTA unit has no experience in seeking external funds.

Ask colleagues in other HB-HTA units about their experience and what funding sources they normally use.

Talk with clinicians in your hospital as they are used to looking for funds for their research projects. They can also help you to identify public and private organisations that could provide external funding . Additionally, clinicians may be interested in including the participation of the HB-HTA unit in their grant proposals.

13.6

The hospital cannot receive directly the external funds that the HB-HTA unit has obtained.

Look for available mechanisms linked (or not) to your hospital that allow you to receive the funds (e.g. work through a hospital/healthcare foundation or other foundation in your region).

Ask clinicians of your hospital about the mechanisms they are using to address this matter.