The government's latest idea to secure faster uptake of NICE-approved medicines throughout the National Health Service has not gone down well with GPs, with fears over restricted freedoms and lack of funds.
Just a few days ago the government unveiled plans designed to ensure that NHS organisations comply with NICE guidance, including an 'innovation scorecard' that will allow patients and the public to see how quickly NICE endorsed medicines are being provided.
"NHS organisations must make sure the latest NICE-approved treatments are available in their area, and if they are not, then they will now be responsible for explaining why not," the Department of Health said, explaining its move.
However, in an interview with GPOnline, Richard Vautrey, deputy chairman of the British Medical Association's GP committee, stressed that the scorecard is only meaningful if the health service has enough resources to pay for every medicine recommended by the cost regulator.
"All it is going to indicate is which Clinical Commissioning Groups (CCGs) have the funding available," he told the publication.
The government argues that as NHS organisations get funding for each new NICE appraisal, "financial issues should not be a barrier to the uptake of innovative new treatments."
However, the NHS Confederation's deputy chief executive David Stout points out that the health service is currently facing an unprecedented financial challenge, and that as there is no financial growth, "any new costs have to be offset by savings elsewhere - that is why it is crucial that NHS organisations engage their local communities and clinicians in decisions about priorities".
Patients in danger of being over-treated?
And others foresee issues that are not financially related. In an emailed statement to PharmaTimes UK News, Clare Gerada, chair of the Royal College of General Practitioners, argued that as NICE advice is focused on individual diseases and not the complex patients GPs see, patients could actually end up 'overtreated' if illnesses are treated in isolation.
"While it's important that we follow best practice, we need to be allowed to do things if we know they're in the best interests of patients," she said, and suggests that the DH "promote GPs' professionalism, rather than monitoring everything that can be monitored".
On a different note, Laurence Buckman, Chair of the BMA’s GP committee, warned that the introduction of a "rigid tick-box culture" linked to an "unethical system of financial incentives" could hamper the freedom of clinicians to mould local services.
“We must instead have a flexible, open approach that encourages innovation and patient-focused commissioning decisions," he said, and stressed that the BMA has "deep reservations about the potentially perverse effect of linking funding for patient care or practice resources to inflexible, centrally designed indicators".