PCTs told to explain how drug funding decisions are reached
pharmafile | September 17, 2008 | News story | |Â Â NHS, hcÂ
The Department of Health has written to PCT chief executives requesting information on how they reach funding decisions on new drugs and treatments.
The request narrowly preceded a report published by the Rarer Cancers Forum, which requested information from PCTs using the Freedom of Information Act to highlight the 'postcode lottery' when it comes to funding those drugs not approved by NICE.
Referring to a new patient right recently proposed in the draft NHS Constitution, NHS chief executive David Nicholson reminded PCTs of the need for transparency in decision-making.
The proposal says patients should "expect local decisions on funding of other drugs and treatments to be made rationally following a proper consideration of the evidence".
It also gives patients the right to an explanation about a decision if their local NHS decides not to fund a drug or treatment that either a patient or their doctor feels is right for them.
Nicholson said the proposed right was intended "to help address perceptions that variations in the availability of important treatments can sometimes occur at random, rather than as the result of a clear and conscious commissioning process", underlining the need for this perception to be "visibly address[ed]".
The Department has asked the National Prescribing Centre (NPC) to begin "urgent work" to determine existing PCT arrangements, both for initial funding decisions on new drugs and for exceptional case funding requests.
David Stout, director at the NHS Confederations PCT network, said the interest from the Rarer Cancers Forum was not surprising given that a specific element of July's draft NHS Constitution concerned new transparency rights.
He also said he did not expect the NCP report to specifically address consistency, adding "it is feasible to have robust decision-making processes that are not always identical".
But he said it was understandable that there was a public expectation of a national standard. Though the survey will not immediately deal with this, he said it was possible that some work would be carried out on this area in the future.
The NPC will draw up a set of "headline principles", along with "good practice guidance" for PCTs, which would be made available to the public and to which the PCTs would be expected to refer when making decisions.
Penny Wilson-Webb of the Rarer Cancers Forum welcomed the development, but warned that legislation was the key to forcing PCTs to comply.
"[The Department has] got to put some weight behind it," she said. "There has to be legislation. The pressure needs to be constant."
Urging PCTs to cooperate with the NPC, NHS chief executive Nicholson said consideration of policies on prescribed drugs was "an area of particular concern".
He stressed that although the patient rights outlined in the draft Constitution were subject to consultation, he was keen for PCTs not to wait until its publication before addressing this area. He also urged PCTs to "satisfy" themselves that their current arrangements were "as robust as possible".
Adelphi Research UK have been appointed by NPC to carry out the study, and further consultations will take place in the Autumn prior to the publication of the Constitution.
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