June 27, 2022
NICE TA drugs
As we move into year 2 of the delayed implementation of NICE TA drugs and treatments doubt remains over how successful implementation has been and how that success is being measured. It was reported at the end of last year that patient uptake had been lower than expected. States members asked questions of the President of the CfHSC at the December meeting and again in June but no information was provided. Deputy Prow (a member of the previous CfHSC) is in the process of submitting a series of Rule 14 questions to the CfHSC, which we hope will tell us how many people have benefited in the first year and how much it has cost. The CfHSC is scheduled to bring forward its Review of the practical application of NICE TAs to the States in the middle of 2023.
We have continued to press HSC to publish the revised version of G1033. This document sets out the guiding principles on which HSC makes its decisions on resource allocation. G1002 which explains to clinicians and their patients how Individual Funding Requests can be made is particularly impacted. Without knowing how the rules are currently applied it is proving very difficult to challenge HSC on some decisions.
A scheduled meeting in May with our Chief Pharmacist, Beverley Hall and the States Prescribing Officer, Geraldine O’Riordan has not taken place and currently no date is set. This is disappointing.
We are in the process of challenging HSC on a policy that appears to add a 25% mark up on to the cost to HSC of providing a drug or treatment. What appears to be a “profit” is in addition to a significant PEH pharmacy dispensing charge and an hourly rate for any treatment provided at the hospital. These charges are applied to all patients that self fund, regardless of their personal circumstances. This policy was brought to the attention of the CfHSC in April. They are still considering their response.
Primary Care Survey
We were actively involved with CareWatch, HSC and Island Global Research, in framing the questions that formed the Primary Care Survey. The recently published survey results will inform the Joint ESS/HSC political working group who are due to bring back a Review of Primary Care to the States in September. Key findings from the survey include clear evidence of inequalities in healthcare seeking behaviour associated with a households financial position. Perhaps not surprising news to many of us but importantly now clearly quantified.
We were also asked by the policy officer in charge of the Primary Care Review to assist with a review of the funding of disability-related equipment, aids and adaptions which is currently provided for under section 10 of the Income Support (Guernsey) Law. It is acknowledged that this is an area requiring transformation in order to be more structured, fair and effective, consistent with the principles of Partnership of Purpose and the UNCRPD. A first meeting to facilitate information sharing was hosted by the GDA on 8th June.