NHS Influencers - The National Institute for Clinical Excellence

Earlier in 2004, the cancer czar Mike Richards published Variations in usage of cancer drugs approved by NICE, an overview on the uptake in the NHS of new cancer drugs — a major cost expenditure in acute trusts. This review was announced in 2003 following a high profile report from CancerBACUP on the use of Herceptin and lobbying by some companies. Whilst the report stresses that many more people are getting access to cancer drugs evaluated by NICE, it also makes clear that the NHS can do more as variation in usage still exists across the country. The report suggests the reasons for variation are complex but do not appear to be associated with direct funding restrictions on the use of these drugs. Instead the main impact on usage seems to be constraints in service capacity and differences in clinical practice. Mike Richards concludes his report with a number of recommendations, which ministers appear to have accepted in full. The use of IMS data in the cancer report is interesting, because the DH has no such data! So note that e-prescribing for hospitals is to be brought forward to 2006 (similar to prescribing audits such as GPs’ PACT (prescribing analysis and cost tabulation)).

Allied to this, the DH has also published a short paper on Implementation of NICE guidance, which ‘asks’ SHAs to ‘consider’ ways of beefing up collective commissioning and to ‘provide a formal commentary on the findings for the cancer networks for which they are responsible’ and ‘to outline actions they intend to take to prevent postcode prescribing.’ The report also talks about the proposals regarding national healthcare standards (which the Healthcare Commission takes into account when reviewing trusts) and that recommendations in technology appraisal guidance will be in the ‘core’ standards for the NHS.