Table 4.

Opportunities for improvement identified in evaluation (Needs assessment for program revision)

Needs	Evidence of need
Governance
TCPC members should be of sufficient levels of seniority, credibility and influence to make and implement appropriate and acceptable decisions	Feedback suggested that all Medical Program/Division Directors and General Manager of Allied Health should be on the committee to own and drive decisions within their programs
Expertise on infrastructure and equipment needs, contracts, maintenance, etc. should be available in the TCPC process	Applicants are corresponding with manufacturers/suppliers directly but do not have knowledge of contract negotiation, maintenance requirements, etc.
Decision-making
Evidence provided should be based on a rigorous systematic review of the research literature	Applicants are not following guidance to undertake systematic reviews properly and not using templates in application form correctly. CCE frequently identifies existing systematic reviews or other evidence that has not been included by applicant.
Application process
Independent experts should identify the best available evidence from the research literature	▪ Applicant feedback is that they do not have the time, knowledge and skills to do this properly ▪ Applicants do not seek help from experts as required/recommended ▪ Information provided is incomplete, inadequate and/or incorrect ▪ Lack of objectivity results in overestimates of outcomes, underestimates of costs
Independent experts should identify issues relating to resources (financial, space, equipment, staff)
Expression of Interest form should replace current application form	▪ Applicant feedback is that form is not user friendly ▪ Project team observation is that form is not used correctly
Business Case template should compare new TCP and current practice ‘head-to-head’	Current process uses different methods to assess costs and resource utilisation for new and current
Monitoring and reporting
Ethics approval as a Quality Assurance activity is obtained prior to data collection	Audits of patient information should be covered by ethics approval
Resources
Data collection tool and Report proforma for diagnostic tests is available	Current Data collection tool and Report proforma are based on Department of Health requirements and only apply to therapeutic interventions. They do not support reporting of diagnostic tests.
Sufficient staffing levels are provided for expert and independent input to application process	Relevant staff have full workloads and cannot add this unless other work is re-directed