The must read stories and talking points from Wednesday

Judge calls out NHS England ‘nonsense’

Wednesday was a tough day in court for NHS England.

The commissioning body faced a mauling by High Court judge Mr Justice Collins over its decision not to fund a cost effective drug to treat a teenager suffering from severe narcolepsy – a neurological condition that has severe impact on sufferers.

The judge gave NHS England a number of opportunities to reverse its stance but the commissioning body’s lawyers pressed ahead – resulting in a predictable defeat and a decision by the judge to issue a rare mandatory order.

This requires NHS England to provide funding for sodium oxybate in a three month trial costing £2,000 – which was all her consultants and legal team were asking for.

The case goes to the heart of NHS England’s approach to specialised commissioning and how it deals with individual funding requests for patients with rare conditions.

Despite this girl’s condition being described as deteriorating, the panel decided she was not an exceptional case – a position the judge said was “nonsense.”

Lawyers for the girl’s family also accused NHS England of discrimination because at least 194 other NHS patients receive funding for the drug and the Department of Health is also funding private prescriptions for sodium oxybate to people whose narcolepsy may have been caused by the swine flu vaccination Pandemrix.

The ugly RTT picture

NHS Improvement has launched a £2m project to see how many patients on trust waiting lists for elective procedures are people needing treatment and how many have been misrecorded.

The regulator approved the project at its board meeting in March and will validate waiting list data at 60 providers.

In some cases trusts with large waiting lists will have failed to remove patients who have been treated, in others patients have not been included on waiting lists when they should have been.

HSJ’s senior correspondent covering acute care, Ben Clover, says the project is significant: “The validation work’s significance can be gauged from two things: the number of trusts being looked at – 60 is more than a third of the acute sector; and the cost – RTT data costs £3m a year to collect overall, so validation costing £2m is significant.

“The centre will be hoping the validation exercise will identify significant numbers of patients who have been treated but mistakenly left on the system.”

Earlier this year we revealed there were thousands of patients waiting more than a year for treatment on the waiting lists of trusts that had stopped reporting data to NHS England. Meanwhile, performance on waiting times for elective procedures has declined, with the overall size of the waiting list now above 3.5 million.

HSJ’s expert says the regulator high hopes for turning this situation around. “NHS Improvement believes that if emergency department performance and the money situation are taken care of, then RTT will take care of itself.

“This looks less and less likely as the overall waiting list stubbornly continues to grow.

“Exercises like this data validation and more trusts actually reporting their figures will make the waiting list picture clearer, but it won’t make it any prettier.”

Most worryingly, he writes: “Patient care scandals look to be in the post on RTT, and some may already have happened.”