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Call for NHS England to ‘think again’ on limiting treatment

Patients Association slams plans to restrict treatments

Jo Carlowe

Wednesday, 03 October 2018

The Patients Association is calling on NHS England to reconsider its plans to restrict the availability of some surgery and other medical interventions.

Patients responding to an Association survey, expressed concern about a “rolling programme” to make the changes. The Association also found patients had relatively little confidence in NHS England’s ability to take decisions of this sort.

The survey results included testimony from patients who had missed out on treatment because of rationing decisions, and found that in these situations the most common end result was for patients to go without “and potentially suffer harm,” rather than be able to successfully challenge decisions.

Key findings included 56% of patients saying they were not happy with NHS England’s general approach to restricting access, and 66% not supporting a rolling programme of restrictions. Nearly a third (31%) of patients believed that none of the reasons offered by NHS England justified restricting access.

Rachel Power, chief executive of the Patients Association, said: “While it’s right that the NHS spends its money wisely, we are concerned that these proposals will put new barriers between patients and the treatments they need. On paper this shouldn’t be a problem, but in reality we know that there will be mistakes and variation, which will lead to some patients missing out.

“With decisions about different priorities being a major part of the development of the new long-term plan for the NHS, it seems strange to make decisions about these treatments in isolation. We would like to see NHS England look again at these proposals in light of its additional funding and forthcoming ten-year plan.”

The Patients Association’s response to the Consultation on Evidence-Based Interventions can be read here.

NHS England, in launching the consultation, stated: “Research evidence shows some interventions are not clinically effective or only effective when they are performed in specific circumstances. And as medical science advances, some interventions are superseded by those that are less invasive or more effective.

“At both national and local levels, there is a general consensus that more needs to be done to ensure the least effective interventions are not routinely performed, or only performed in more clearly defined circumstances.

“We have formed a new national collaboration with the Academy of Medical Royal Colleges, NICE [National Institute for Health and Care Excellence], NHS Clinical Commissioners and NHS Improvement’s GIRFT [Getting It Right First Time] programme to turn this consensus into action – the Evidence-Based Interventions Programme.”

NHS England in its FAQ has stated the plans are not rationing, but aimed to ”reduce avoidable harm to patient”, ”save precious professional time”, “help clinicians maintain their professional practice in line with the changing evidence base”, “create headroom for innovation,” and “maximise value and avoid waste”.

NHS England will announce its decision later this financial year, with any changes added to the 2019/20 version of the NHS Standard Contract.

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