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PCTs bypassed in applications to Cancer Drugs Fund

Doctors have been told they can bypass primary care trust funding processes and apply direct to the controversial Cancer Drugs Fund in certain cases, under new guidelines issued by the Department of Health.

The revised guidelines published this week make it clear that specialists can apply directly to the government’s flagship £200m fund for drugs already listed for fast-track approval by regional clinically-led panels.

Previously doctors may have felt it necessary – or been required by PCTs – to make individual funding requests before turning to the fund, despite knowing these would be turned down.

Under the revamped guidelines regional panels are now “strongly encouraged” to draw up lists of treatments they will automatically fund for certain groups of patients.

“Evidence has shown that such an approach provides transparency, equity and speed of decision-making, reduces the burden on clinicians and managers and supports forward planning use of funding,” says the document.

The DH also revealed it would undertake an audit of the fund, set up after the election to fulfil a major Conservative election pledge. New guidance will set out plans for more stringent monitoring.

The announcement came in the week it emerged more than £60m of the £200m allocated for 2011-12 had not been spent.

All strategic health authorities have agreed to take part in the audit, which will be co-ordinated by the National Cancer Action Team and feature a national database to be developed and managed by the Oxford Cancer Intelligence Unit.

SHAs will provide both new data and information on past cases including the type of drug prescribed, the treatment regimen, length of treatment and when patients died.

Health minister Lord Howe said the audit would “help provide evidence from drugs funded through the fund for the benefit of wider NHS practice”.

The audit has been welcomed by cancer charities, including Macmillan Cancer Support, which said it would provide useful information on the effectiveness of certain drugs – especially when it came to treating rarer types of cancer.

However, there is no commitment in the document to publishing the data or how it might be made available.

Gus Baldwin, head of public affairs at Macmillan, said he hoped the DH would ensure results were published regularly.

He also called on the government to make it clear what will happen when the Cancer Drugs Fund ends in 2014 and a new value-based pricing system is introduced.

“We want all the treatments that are made available through the Cancer Drugs Fund to be automatically available to cancer patients on the NHS when the new system is launched,” he told HSJ.

In the meantime the organisation highlighted a need for more research into why Cancer Drugs Fund money was not being spent.

“We need to understand why the underspend is happening,” said a spokeswoman. “It could be for a whole range of reasons and not simply because people are having drugs refused.”

These could include regional variations in applications, clinicians taking a different approach or because there is less need in some areas.

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