A key part of our work at Health Technology Wales (HTW) is the appraisal of non-medicine health and social care technologies and models of care and support; this is also known as health technology assessment (HTA). We research and evaluate the best available effectiveness and cost-effectiveness evidence about a health or social care technology. Based on this evidence, we publish guidance on whether the health or social care technology should be adopted for use in Wales.

Topic proposer submits a potential topic for appraisal


Is the topic appropriate for HTW appraisal
Topic proposer is invited to present on their topic at Assessment Group


Topic is not added to the appraisal work programme


Topic is added to the appraisal work programme
Stakeholders help develop the topic protocol
HTW team produce the Topic protocol
Topic proposer and independent experts review the EAR and submit comments
HTW team evaluate the evidence and produce the EAR
The Guidance (GUI) and EAR are finalised

‘Adopt or Justify’: NHS Wales should adopt this advice or justify why it has not been followed.

HTW will evaluate the impact of our advice


  • HTW: Health Technology Wales
  • TER: Topic Exploration Report
  • EAR: Evidence Appraisal Report
  • GUI: Guidance

Appraisal Process Guide

This guide describes the processes that Health Technology Wales follows when carrying out appraisals for health and social care.

This document explains the process we use for appraisals, including:

  • Initial topic submission and selection
  • Production of a Topic Exploration Report
  • Selection of topics for further work, in the form of an Evidence Appraisal Report
  • Production of an Evidence Appraisal Report
  • Production of guidance

It also describes what happens after an appraisal: how we monitor the impact and adoption of our guidance, and the circumstances under which we might change or revisit existing guidance.

 Appraisal Process Guide summary

A shorter plain language summary of our Appraisal Process Guide can be found here.

Appraisal Process Guide

Suggesting a topic

We actively seek topic suggestions from within the NHS and from social care professionals or providers, but anyone can suggest a health and social care technology topic for us to consider through our suggest a topic form. See our Reports & Guidance for examples of previous topics we have received.


Topic exploration

If a suggested topic is within our remit, we will then look at whether there is enough available evidence to do an appraisal and whether the topic meets our appraisal selection criteria. These considerations are outlined in a Topic Exploration Report. This report is taken to the Health Technology Wales Assessment Group, and the topic proposer is invited to present. If the Assessment Group decide that the topic is appropriate and meets our selection criteria, it is added to the Health Technology Wales appraisal work programme.

All Topic Exploration Reports are published on our website, under Reports & Guidance, outlining the reasons for accepting or rejecting a topic for the Health Technology Wales work programme.


Assessing the evidence

We collaborate with the topic proposer and experts to develop a protocol for the topic. The protocol covers what is known about the topic so far, the research question that we want to answer and the criteria for selecting studies to include in the appraisal.

Using the protocol, we complete a rapid review (and any other investigations that are needed) of the available evidence. We assess the evidence and draft an Evidence Appraisal Report (EAR). The draft EAR is reviewed by experts and the Health Technology Wales Assessment Group and Appraisal Panel before finalising.


Developing Guidance

The Health Technology Wales Appraisal Panel appraises the evidence within the EAR and makes sure that the implications for NHS Wales and the social care sector in Wales have been properly considered. The panel includes senior representation from each local health board and partners from social care with delegated authority to issue HTW Guidance. The guidance summarises key evidence and implications for the  health and social care technology or model of care and support in Wales.


Public communication/dissemination

Once finalised, the EAR and Guidance are published on the Health Technology Wales website and sent out to key stakeholders working within welsh care systems. We also share our publications through our social media channels and quarterly newsletters.


Status of HTW guidance

Our guidance is not mandatory, but there is an expectation from Welsh Government that our guidance is adopted. The status of HTW guidance is ‘adopt or justify’. Each local health board and other relevant bodies are expected to report on how they have considered our appraisal and guidance. If they have chosen not to adopt HTW guidance, they are asked to outline their rationale and justify their decision. We regularly monitor adoption of guidance on non-medicine health and social care technologies. This includes HTW guidance and guidance from other organisations, such as NICE (The National Institute for Health and Care Excellence).