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New rules to tackle drugs lottery

More details have come to light of how hospitals that delay acting on National Institute for Health and Clinical Excellence guidance will be forced to explain hold-ups to patients.

The new rules, brought in to tackle perceived disparities regarding available treatments, will allow the public to see ‘scorecards’ comparing the speed at which hospitals roll out innovative care methods and medicines.

Currently primary care trusts (PCTs) in some areas delay offering new drugs as recommended by the National Institute for Health and Clinical Excellence (NICE), while in other parts of the country they are available to patients straight away.

Under the scheme, which is expected to be rolled out before autumn, hospitals will have “no excuse not to provide the latest NICE-approved drugs and treatments”, the Department of Health said.

Organisations will be automatically added on to publicly available lists of what drugs are available in local areas.

It is hoped the rules will create a level playing field for treatments such as IVF, for which patients living in different regions have had varying levels of opportunity for the treatment.

Last year a report found more than 70% of NHS trusts were ignoring NICE guidance to offer infertile couples three chances at IVF, and some stopped funding treatment altogether.

The study, from a cross-party group of MPs, found PCTs placed strict restrictions on who is eligible for IVF.

Most PCTs put limits on the age at which they will treat women - but one PCT was only allowing women to be treated between the ages of 39 and 40.

This means younger women can wait years for NHS treatment despite the fact fertility declines with age.

Some of NICE’s most recent guidance, recommending an extended time to administer a clot-busting drug to treat stroke patients, for example, will soon have to be taken on by all hospitals.

Readers' comments (4)

  • Surely it's the commissioners (PCTs) who cause the disparity, not the provider Trusts themselves?

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  • RE: Anon 1.05pm
    Not necessarily. If the provider trust has teams that are less experienced in using innovative medicines or if they have capacity issues, then a treatment could have funding granted by commissioners but access be delayed to patients.
    These scorecards would be of most value if they married up the commissioning picture along with the service provided.

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  • This is a confused report. It fails to distinguish between the different types of NICE Guidance which have different implications for NHS commissioners and providers.

    The ONLY NICE Guidance where there is no discretion is NICE Technology Appraisals covered by a 2001 NHS Secretary of State Direction, but hedged by the actual NICE Guidance where treatment is an 'option' and often has associated clinical criteria.

    NICE Infertility Guidance is a Clinical GUideline which is advisory to Commissioners and implementation is aspirational and discretionary, and needs to be considered against other competing priorites. Therefore the 'new rules' refered to cannot apply to IVF.

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  • Quite right Maggie, it's only TAs not CGs but the mainstream press haven't picked up on the difference. The previous poster's also correct - pass through payments facilitate use but there are often other reasons for limited uptake, like clinical confidence or patient flows. I sincerely hope that the point about linking this to commissioning is fed back as part of the public consultation, it's so important.

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