The National Institute for Health and Clinical Excellence proposes to reject a breast cancer drug despite its own rule changes on end-of-life treatments Wednesday 21 October 2009 18.11 BST A drug which can give women with advanced breast cancer extra weeks or months of life has been turned down by a government watchdog body for use in the NHS. The National Institute for Health and Clinical Excellence (Nice) says it proposes to reject Tyverb (lapatinib) in spite of changes in the rules brought in specifically to allow people at the end of their lives to have the chance of new and often expensive treatments. Tyverb is the only drug licensed for women with advanced breast cancer whose tumours test positive for a protein called HER2 and for whom Herceptin, a Nice-approved drug, is no longer working. In much of the rest of Europe, Tyverb is then given, in combination with a standard chemotherapy drug called capecitabine.
A therapeutic programme hailed by ministers as a hi-tech, cost-effective solution to Britain's growing problem of depression and anxiety has been widely ignored by the NHS, leaving hundreds of thousands of people without access to treatment. Opposition politicians and charities have accused the government of creating a postcode lottery.
An investigation is under way into how two transplant patients were given kidneys from a donor with a rare and aggressive form of cancer. The incident at the Royal Liverpool University hospital involved organs from a woman who died at another hospital, and was later found to have had a hard-to-identify disease called intravascular B-cell lymphoma. Both patients had been preparing for live transplants from their sisters but accepted the donor kidneys instead. The recipients are now receiving chemotherapy treatment. Although cancer transmission is a known risk of transplantation among clinicians, the case raises questions about guidance to patients and whether sufficient checks are made. One senior of
The government's kneejerk reaction to allow patients to top-up NHS care with treatment paid for privately is another nail in the coffin of the universal healthcare. We believe sanctioning top-ups is too simple an answer to a very thorny, complex and emotional issue, and doing so risks some serious unintended consequences. There is a danger that this might appease middle England but disregard the real health challenges facing us.
This article examines the implications for patient care, and for the future of rationing within the NHS, of the recent decision to permit NHS patients to supplement their care by paying for medicines — mainly expensive new cancer drugs — which are not available within the NHS. The starting point is the recommendations of the Richards' Report and their implementation through new guidance issued by the DoH and NICE. Practical challenges arise from the insistence upon the 'separate' delivery of self-funded medicines, and more flexible cost-effectiveness thresholds for end of life medicines may have repercussions for other patients. While undoubtedly part of the trend towards explicit rationing, top-up fees might also represent a significant step towards regarding the NHS as a core, basic service. Finally, the issue of top-up fees is located within the broader context of current cancer research priorities and persisting health inequalities.
This article examines the Health and Social Care Act 2012 and associated reforms to the National Health Service in England. It focuses on the Act's policy of making the NHS market more ‘real’, by both encouraging and compelling NHS bodies to act as ‘market players’. The article considers whether the reforms are compatible with the constitutional requirements of accountability for the provision of a public service such as the NHS. It argues that the reforms threaten accountability for three reasons: they make the Secretary of State for Health's relationship with the NHS more complex, they create opaque networks of non-statutory bodies which may influence NHS decision-making, and (especially in relation to competition) they ‘juridify’ policy choices as matters of law. Taken together, these arguments suggest that there is force in the claim that the reforms will contribute to ‘creeping’ – and thus unaccountable – privatisation of the NHS.
The Handbook to the NHS Constitution is here to give NHS staff and patients all the information you need about the NHS Constitution in one place. It acts as a guide to: - patients’ rights and pledges - responsibilities of patients and the public and staff - staff rights and NHS pledges to its staff At the back of this Handbook is an appendix, which outlines the legal source for both the patient and staff rights in the NHS Constitution.
'A new pathway for the regulation and governance of health research' was published in January 2011. The report was prepared by a working group, chaired by Professor Sir Michael Rawlins FMedSci, convened in response to an invitation from Government to review the regulation and governance of UK health research involving human participants, their tissue or their data. The report proposes four key principles that should underpin the regulation and governance framework around health research in the UK, and makes recommendations to: * Create a new Health Research Agency (HRA) to rationalise the regulation and governance of all health research. * Include within the HRA a new National Research Governance Service to facilitate timely approval of research studies by NHS Trusts. * Improve the UK environment for clinical trials. * Provide access to patient data that protects individual interests and allows approved research to proceed effectively. * Embed a culture that value
A trainee teacher with primary refractory Hodgkin’s lymphoma has launched a High Court action against her primary care trust, NHS Surrey, which has refused to pay for her treatment with an unlicensed drug. Philippa Bigham, aged 28, from Frimley, Surrey, has been given a prognosis of two years’ survival without a bone marrow transplantation. But her medical team at the Royal Free Hospital in London want her to have treatment with radiolabelled basiliximab, a monoclonal antibody conjugated with radioactive iodine and also known as CHT-25, before she has the transplantation. The primary care trust has refused to pay for the drug, which costs £3000 ({euro}3500; $4900) for a course of treatment. Basiliximab is licensed in the United Kingdom for use in renal transplant rejection but the radiolabelled version is not yet licensed.
GPs’ representatives voted overwhelmingly this week for a system in which patients opt in to any sharing of medical data with third parties—rather than one in which their consent is assumed unless they opt out, the system favoured by the Department of Health. Clinical confidentiality depends on GPs being the prime data holder of their patients’ medical records, said the BMA’s annual conference of local medical committee representatives in London. It also strongly opposed using implied consent as justification for releasing information on named patients.
The UK government has quietly dropped a passage in the draft handbook to the NHS constitution that said that ministers had decided to give researchers the right to trawl medical records for research participants without the need for patients’ consent. Organisations that are charged with safeguarding patient confidentiality had objected strongly to a section in the draft handbook that said, "Patients can . . . expect that a health professional or a research professional who owes the same duty of confidentiality as a health professional may use care records, in confidence, to identify whether they are suitable to participate in approved clinical trials. Appropriate patients will be notified of opportunities to join in, and will be free to choose whether they wish to do so, after a full explanation."
Although the number of patients seeking treatment elsewhere in the European Union is small,3 this could easily change, especially if people are faced with growing waiting lists or other forms of rationing as the new groups seek to control their budgets. British residents have had the right to obtain treatment in another EU country since 1971.4 Initially, the opportunities were limited mainly to people who fell ill when abroad or, less often, when the NHS agreed that there were good reasons for patients being treated abroad (for example, a citizen of another country resident here returning home to give birth
Patients in England will be able to inspect and correct their NHS and social care records online from 2015 if the coalition government’s vision for the use of IT in the NHS becomes reality.