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QIPP: the cancer drugs perspective
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Richard Hancox, Chief Operating Officer, Nuneaton and Bedworth Clinical Commissioning Group
Introduction
Although the NHS has a settlement that provides an annual inflation uplift on existing budgets for the next 3 years, the financial equation remains very challenging. There are several reasons. For example, the ageing population will make increasing demands on healthcare. In addition, the cost of NHS inflation is driven by technological advance, and is running ahead of general inflation. Indeed, it has been recognised that if the NHS carries on spending as it does now, the potential gap between the resources required and the resources available will be up to £20 billion by 2014/15.1
In this article, I explore the challenge from the national perspective, and some regional and local plans that focus specifically on cancer drug prescribing.
QIPP: the national agenda
The NHS is required to respond to the current financial challenge by adopting a strategy which recognises that:
- Variations remain in the quality of health, care, and use of healthcare services, and there are opportunities to significantly improve quality through raising ‘the many’ to the levels of ‘the best’
- In many instances, improvement in quality can lead to lower costs, e.g. through reducing rates of disease
- Some NHS activity is of low clinical benefit, and it is inappropriate in times of economic restraint for such activity to be allowed to crowd out activity that offers greater clinical benefit
Nationally, the various aspects of the financial challenge to the NHS have been brought together under the banner of QIPP—Quality, Innovation, Productivity and Prevention—and all local organisations in the NHS have been developing plans to realise the opportunities that it offers.
Expert assessments of the QIPP challenge2 have led to the suggestion that, in principle, the opportunities for improvement and the value associated with them can indeed more than bridge the potential financial gap.
Achieving such levels of savings will require an unprecedented degree of cooperation between all organisations in a local ‘health and care system’, working together rather than in isolation.
This need to work together creates an unprecedented leadership challenge for the service.
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Discussion.