NHS finances must improve for NICE guidance
Key messages from the report
Speaking at the launch of the report, Andy
McKeon, chairman of the Audit Commission, said that there are
three key messages to
be
learnt from the report.
“Firstly, the quality of patient
care and the quality of access to care will improve if NHS bodies
sharpen their financial management arrangements.
“Secondly, there
are a series of straightforward, practical steps that NHS bodies
can take to make improvements, such as better budgeting and planning
for the costs of forthcoming guidance.
“Our third point is that
payment by results will change how NICE guidance is funded locally,
so [NHS bodies] need to be clear about what impact it will have,” he
said. |
NHS bodies should strengthen their financial management arrangements in order to improve implementation of National Institute for Health and Clinical Excellence guidance, a report published by the Audit Commission this week argues.
“Managing
the financial implications of NICE guidance,” the
result of a survey of 71 NHS bodies in England and 16 in-depth visits,
found
that only 24 per cent of NHS bodies routinely produce an action plan
for implementation of clinical guidelines and only 12 per cent do so
for technology appraisals. Implementation also varies across NHS bodies
and is, the reports says, “less comprehensive and timely than desired.”
NHS bodies perceived funding to be the biggest barrier to the implementation
of NICE guidance, the report found. A third of respondents identified
guidance NICE issued in 2002–03 that they were unable to fund,
including anti-tumour necrosis factor, photodynamic therapy and coronary
artery stents. And 85 per cent said that the funds available to implement
technology appraisals were insufficient, particularly in relation to
high-cost appraisals, such as etanercept and infliximab for rheumatoid
arthritis. However, the most significant issue identified by the Audit
Commission was weaknesses in local financial arrangements.
The Audit Commission also calls for cost templates to be used more extensively.
Tim Root, chairman of the British Onocology Pharmacy Association, commented: “It
highlights the value of using a cost template as part of the planning
process for implementation. The appendices include an example template
for lung cancer and a business case proforma which identifies pharmacy
services in a list of infrastructure costs to be considered.” He
added that the report highlights the value of multidisciplinary clinical
networks in aiding implementation and quotes examples from experience
in cancer networks.
The Audit Commission also recommends that, in order to account for future
costs, all NHS bodies should undertake continuous horizon scanning for
forthcoming NICE guidance and that they should also consider sharing
the responsibility for horizon scanning across strategic health authorities
or in primary care trust clusters. |
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Pharmaceutical Journal
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