Drug treatment a postcode lottery?

 

NICE states that: "Our advice ends the uncertainty and helps to standardise access to healthcare across the country."

A frequent source of great anger amongst health professionals and patients remains the presence of postcode variations in treatment.

Chief Economist of independent health watchdog The King's Fund, John Appleby, has studied postcode variations. He says that although there are still regional variations, due in part to such issues as the age of populations, the occurence of certain diseases and cases of social deprivation, NICE's guidance on clinicial procedures and drug treatments is being considered on the ground:

 

 

He also believes the individual people involved in decision-making should be considered: "Within hospitals and within Primary Care, there are thousands of clinical decision makers, there are nurses, there are doctors, and they are all making decisions about individual treatments for individual patients and we know from research that those individual decisions will vary."

In a major shake-up of local health services last October, the government decided to cut the number of Primary Care Trusts, the local commissioners of health care, from over 303 to 152.

PCTs have the responsbility to spend around 80% of the budget for the NHS.

Also enforced were a series of new financial targets to curb administration costs and free up more money for the purchasing of services.

Labour MP Dr Ian Gibson admits the aim of more equal local services has still not been met:

 

 

Former Conservative shadow health minister John Baron MP believes PCTs are suffering unduly and reforms within NICE are needed:

 

Regardless of their particular funding allocations, PCTs have a legal requirement to heed all NICE guidance on drug treatments. If a drug is approved it must be brought into use in three months.

NICE does provide an Implementation Support programme to help local authorities follow their clinicial guidance, but NHS Alliance Chief Executive Michael Sobanja, believes PCTs need greater support from NICE and the Department of Health:

Consultant in Public Health at Southampton PCT, Dr Bob Coates, says that he and his colleagues feel great pressure from new treatments:

Professor Nick Bosanquet believes NICE is aware of funding pressures within the NHS:

 

NICE guidelines relating to the funding of treatments they recommend states: "The NHS is legally obliged to fund and resource medicines and treatments recommended by NICE's technology appraisals."

NICE is an independent institute and not part of the NHS.