Tuesday, 2 November 2010

NHS Reform – not so NICE for GPs?

Yesterday the UK Department of Health announced that NICE (National Institute for Health and Clinical Excellence) is to lose its power to reject the funding of new medicines for use on the NHS. It will continue to give advice and guidance on the efficacy of drugs, but will not decide whether patients should be given the treatments their doctor recommends.

It will now be GPs who decide if a drug should be funded and there will be a new system of ‘value based’ pricing.

Andrew Dillon, the Chief Executive of NICE commented ‘We support the moves to extend access to new treatments at prices which reflect the additional value to patients. NICE is the global leader in evaluating the benefits of new drugs and we anticipate being at the heart of the new arrangements’

I am relieved that NICE will still be involved as an independent review body, assessing the value of new drugs and existing drugs for new indications. But how are GPs going to make ‘value based decisions’ on medicines? They will either need to dedicate more time to this complex task or employ people who know how to do this – i.e. the existing procurement and medicines management teams currently employed by the Primary Care Trusts.

So is this really same old same old? Same jobs but different titles and where is the saving in that?

Dr Laurence Buckman, Chairman of the BMA's General Practitioners Committee voiced his concerns stating ‘The thing I find worrying is this suggestion that you go to your GP and your GP decides whether or not you cab have that particular drug or not This is going to make GPs rationers of healthcare and many will feel very nervous about that’

So let me summarise…

As a result of the NHS reforms GPs will…
Ø        Create and operate Consortia to control spending
Ø        Hold power and responsibility for £80 billion of healthcare budget
Ø        Make purchasing and commissioning decisions on primary, secondary and tertiary care
Ø        Be measured on ‘outcomes’ not ‘targets’
Ø        Make decisions on the availability and funding of medicines
Ø        Be required to keep records of their own performance, and produce reports on mortality rates.

Ø        And one more important function…

Let me think – what is that important function?

Ah yes – I remember now…...

Ø        Look after patients.


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