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Wednesday, February 3, 1999 Published at 16:14 GMT


NHS body 'to end postcode prescribing'

New body will decide which drugs and treatments should be used

The government has issued details of the body that will decide which new drugs and treatments can be made available on the NHS.

The National Institute for Clinical Excellence (NICE), launched on April 1, will lay down 10-15 guidelines a year on best treatments, and appraise up to 50 drugs and medicines for cost effectiveness and clinical efficiency.

NICE will be made up of a team of 12 professionals, chaired by Sir Michael Rawlins, professor of clinical pharmacology at Newcastle University.

The aim is to ensure doctors across the country work from the same guidelines and end so-called rationing of treatment "by postcode" where treatments are available from one health authority, but not another.

Health Secretary Frank Dobson said: "NICE will command the respect of doctors, nurses and other clinical professionals and provide authoritative guidance on what treatments work best for patients.

"Its evidence-based guidelines will be used right across the country so NICE will help end the unacceptable geographical variations in care that have grown up in recent years."

Increase speed

[ image: Frank Dobson promised an end to care by postcode]
Frank Dobson promised an end to care by postcode
Mr Dobson said NICE would help to speed up the pace at which good value treatments are used across the NHS.

In the past, he said, this has often been too slow in some places.

For example, even 15 years after the initial discovery of the benefit of eradicating H pylori in the treatment of ulcers, many patients are still not receiving the best drug treatment to get rid of it.

"This in turn will promote and encourage successful innovation on the part of clinicians, pharmaceutical companies and the medical devices industry," Mr Dobson said.

"Equally, by sorting out the wheat from the chaff it will be able to target treatments on patients who will benefit most, and protect patients from outdated and inefficient treatment."

The government is also confident that NICE will help clinicians by reducing the number of often contradictory guidelines they are sent by many bodies, some of which lack scientific rigour.

For instance, three separate regional bodies issued guidance on the use of riluzole for treatment of motor neurone disease, coming to distinctly different conclusions.

Doctors supportive

Doctors have also broadly welcomed the introduction of the body which they hope will clear up confusion over prescribing new medicines.

A spokesman for the British Medical Association (BMA) said: "We have been calling for a national debate about rationing and national guidelines on new and expensive drugs for a long time, and we hope that NICE is the vehicle that will allow this to occur.

"We also hope it will prevent the continuation of postcode prescribing."

At the moment the Health Secretary rules on whether to allow new and costly drugs to be prescribed on the NHS.

The flaws of the current system were exposed last month when the BMA condemned Mr Dobson's decision to limit the NHS use of the anti-impotence drug Viagra.

A final decision on exactly which classes of patient will be eligible for the anti-impotence drug is set to be made in the next month.

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