NPC Archive Item: Department of Health consultation on draft guidance for NHS patients who wish to pay for additional private care

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Department of Health. Draft guidance on NHS patients who wish to pay for additional private care — a consultation

This draft guidance constitutes part of the government’s response to Prof. Mike Richards’ review entitled Improving access to medicines for NHS patients. The remit of the review was to examine if, when and in what circumstances patients should be able to purchase additional drugs that are not funded by the NHS. The purpose of the Department of Health (DH) consultation is to obtain views on the implementation of the policy the government has adopted in the light of Prof. Richards’ recommendations.

Comments on the questions for consultation can be made until January 27th 2009. Details of where to send those comments can be found within the document.

What is the background to this?
Prof. Richards’ review was established to examine the current policy relating to patients who choose to pay privately for drugs that are not funded on the NHS and who, as a result, are required to pay for the associated care that they would otherwise have received free on the NHS.  Advice was to be given to the Secretary of State for Health on how policy or guidance could be clarified or improved. The Secretary of State has accepted the detailed recommendations of the review. A summary of these follows:

  • The Department of Health should make clear that no patients should lose their entitlement to NHS care that they would have otherwise received,  because they opt to purchase additional care for their condition;
  • Revised guidance should be issued as soon as possible to make this clear and to promote greater consistency across the NHS in England; and
  • The guidance should set out mechanisms to ensure that these cases are handled in a way that supports good clinical practice and is fully consistent with the fundamental principles of the NHS.

What is the purpose of the consultation?
The consultation paper now provides new guidance on the process to adopt in situations where NHS patients wish to buy additional secondary care services that the NHS does not fund.

The government has produced an Equality Impact Assessment document in conjunction with the consultation. This makes clear that patients should not lose their entitlement to NHS care if they buy additional private drugs, as long as the private care is delivered separately.

This guidance should also be considered in the context of the Secretary of State’s announcement that:

  • NICE will have more flexibility regarding the approval of expensive drugs for terminally ill patients suffering from conditions where the eligible patient population is low
  • The timeliness of NICE guidance is being improved
  • Work is being undertaken with the pharmaceutical industry to achieve agreement over arrangements to supply drugs at a lower initial price
  • The quality and consistency of local decisions on funding drugs where there is no NICE guidance in place is being improved.

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