Patients in England to be allowed to top up NHS care.

Patients will be allowed to pay for medicines not available on the NHS without forfeiting their right to free NHS care, under plans launched on 4 Nov 20008 by the Department of Health.

The national clinical director for cancer Professor Mike Richards' report “Improving access to medicines for NHS patients” sets out a series of recommendations on improving access to medicines for NHS patients.  It also makes recommendations on the consequences for NHS patients of seeking additional private care.  Professor Richards presented his report to the Secretary of State for Health Alan Johnson ; who accepted the recommendations in full on 4 November.

Mr Johnson said “This issue was causing uncertainty and stress to patients and their families at a very difficult time in their lives,” adding that there was a need to tackle the underlying causes fuelling demand for patients to top up their care.

“But there will always be a small number of cases where patients opt to buy additional drugs,” he went on. “In these cases, NHS care should never be withdrawn: private care must take place separately in a private facility to ensure fairness; NHS funds must never be used to subsidise private care; and NHS patients must never be charged for their care.”

Nonetheless, the DoH expects that few patients will need to resort to topping up their care privately. The package of measures to improve patient access to medicines includes a proposal from the National Institute for Health and Clinical Excellence to allow for greater leeway in the appraisal of expensive drugs for terminally ill people consultation on new measures 

Until now, Nice would not approve drugs that cost more than £30,000-48,000 for a year of good quality life. The ceiling will now be as high as £80,000 a year for cancer drugs that could offer patients a few more months.

The move opens the way for approval of some of the kidney cancer drugs Nice has recently rejected, which led to an outpouring of anger by patients and doctors.

The DoH is now consulting on guidance for NHS organisations to deal with NHS patients who decide to pay for additional private care. The guidance “does not permit a ‘pick and mix’ approach where patients can pay to upgrade any individual elements of their NHS care”, states the draft document.