Cancer Commissioning—at a global and a local level: London Cancer New Drugs Group Annual Meeting

Additional private care in practice contd.

Current NHS guidance (March 2009) encourages patients to explore all reasonable avenues for NHS funding before turning to the additional private care option. “There is no absolute requirement to go down the IFR route, particularly if so-called ‘exceptionality’ is the basis for such an option,” he insisted. In practice, additional private care is judged to be an option only if all other avenues have been exhausted—i.e. no NICE approval, no local PCT agreement, no clinical trial evidence and no IFR criteria.

Feedback from Mr Webb’s approach to the Association of Teaching Hospital Pharmacists has indicated that there is likely to be very little activity on the additional private care front. Indeed, of the 18 teaching hospitals that responded to Mr Webb, 12 had seen no such activity whatsoever.

• NICE guidance seemed to have been helpful in obviating the need for additional private care, but there are still issues surrounding:
• The diagnostic context in which drugs might be prescribed privately
• Safety and clinical governance
• The way in which additional private care costs are handled in NHS hospitals
• For the future—pressure on the NHS to make certain novel drugs available earlier than might otherwise have been the case

In a final warning about the potential impact of the credit crunch, Mr Webb said: “It would be unfortunate if the additional public care given to the banking sector meant that there was a greater reliance of NHS patients paying for additional private care.”

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