GPs will do the job of NICE
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GPs will do the job of NICE
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GPs could face lobbying from their patients, pharma companies and who knows who else if they are given the responsibility of deciding which drugs they'll provide, A report in Pulse which follows a st
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Forums » Off duty » News & media » GPs will do the job of NICE
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GPs will do the job of NICE
posted at 2/11/2010 11:09 AM GMT
on bmj.com
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*Moderator*
Posts: 593
First: 17/11/2008 Last: 15/5/2012 |
GPs could face lobbying from their patients, pharma companies and who knows who else if they are given the responsibility of deciding which drugs they'll provide, A report in Pulse which follows a story in the Guardian, says that NICE will not longer mandate which drugs they will provide. The story says The Government has revealed it intends to remove the job of deciding which drugs are available on the NHS from NICE - and give the responsibility direct to GPs instead. In a major shake-up of the rationing of treatments on the NHS, NICE drug appraisals will become advisory – rather than statutory – and the decision about whether a patient receives a particular treatment will be taken at a local level by GPs. The www.dh.gov.uk/" target="_BLANK">Department of Health says this development will be accompanied by a move towards ‘value-based’ pricing, where the price of treatments ‘will reflect the value they bring’. http://www.pulsetoday.co.uk/story.asp?sectioncode=23&storycode=4127560&c=2 Does this mean a return to postcode lotteries and do GPs want to take over this remit from NICE as it could make them pretty unpopular. |
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Re: GPs will do the job of NICE
posted at 2/11/2010 8:00 PM GMT
on bmj.com
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Posts: 261
First: 10/12/2008 Last: 20/3/2012 |
I was surprised and a bit shocked to hear this. I think this is one step too far. Many GPs respect the role of NICE and their decisions and some of these were difficult decisions but at least you know they had been through a thorough appraisal process and I have had no problems defending some of their decisions. Of course this will start up a post code lottery on access to treatments-one of the reasons Nice was brought into being in the first place was to avoid this...and the inverse care law will prevail. I'm not particularly skilled at appraising new drugs, undertaking cost benefit analysis and communicating this. This whole GP commissioning world is becoming less and less attractive. I do think in certain cases GPs are well placed and have the skills to explain rationing decisions to patients- even why someone should not necessarily have access to some of these so called "life saving drugs" as they are presented by the media. I don't think we should be prescribing hugely expensive treatments with nasty side effects that may give someone a few more weeks of life -but we need doctors to all sing from the evidence based song sheet and there are lots of vested interests -not a only the pharmaceutical companies but other doctors.. In recent weeks I have explained to some of my patients why I would prefer them to go to a cheaper provider for their care (quality not an issue here) rather that their "choice" and have been surprised how understanding people have been when presented with the stark financial facts. Yes it's going to be tricky to remain the patient advocate when as GPs we will have vested financial interests in keeping the service going. What a bomb that is being handed to us! Kate |
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Re: GPs will do the job of NICE
posted at 2/11/2010 9:08 PM GMT
on bmj.com
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Posts: 75
First: 16/12/2008 Last: 24/4/2012 |
I'm guessing individual GPs won't be making on the spot decisions. It would obviously place us in an untenable position. One minute we're providing palliative care to a patient with metastatic breast cancer and supporting her family. The next, we'll be deciding whether to "grant" her access to life extending drugs. I don't think so. At the moment, if we want to prescribe drugs in exceptional circumstances, we apply to the PCT. I presume that the same GPs who are willing to sit on that committee will be coralled into a commissioning group committee which will fulfill the same purpose but with a new title. The rationing will be according to commissioning group rather than postcode. NICE weighed the current evidence, listened to interested parties and then made recommendations. It was a largely fair, rational, and independent body which used experts to inform its difficult decisions. GPs work as advocates for their patients. We're not generally scientific experts and its hard to be rational when you're the one holding a dying patient's hand. We should resist this most unwelcome development. |
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Re: GPs will do the job of NICE
posted at 4/11/2010 11:27 AM GMT
on bmj.com
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Posts: 116
First: 14/9/2010 Last: 7/2/2012 |
There was an article in the Guardian by Polly Toynbee and then this letter which I find myself agreeing with 100 percent. "Nice is not perfect, but it is highly regarded around the world and it has served as a model for comparable institutions which have emerged. So it seems bizarre that Lansley is proposing to return to a situation in which geographical inequities in access may once again become the norm, especially as it will prove more difficult for a cash-strapped government to monitor decision-making diffused among GPs. There is scant evidence that GPs wish to be scapegoats for emotive and unpopular decisions to restrict access to new treatments. The only people who are likely to welcome this decision are Daily Mail columnists. And Lansley may find himself losing their support as well, once the first instance of postcode prescribing is reported." http://www.guardian.co.uk/politics/2010/nov/04/nice-new-nhs-lottery |
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Re: GPs will do the job of NICE
posted at 8/11/2010 9:39 PM GMT
on bmj.com
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Posts: 25
First: 3/6/2010 Last: 14/3/2012 |
If GPs are to replace NICE, then this change must be reflected in a change in the medical course at University - soon. If GPs are forced to make such decisions without the required knowledge and skils, it could be disastrous for all... |
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