A new Audit Commission list that identifies procedures of “low clinical value” and recommends their phasing out by the NHS has been described by a leading industry and patient organisation as “indiscriminate and damaging”.
The list could lead to innovative treatments including hip and knee replacements, neurostimulation to relieve pain and cochlear implants to restore hearing ceasing to be available on the NHS. Many of these procedures are recommended by NICE.
Compiled by a number of London PCTs including Croydon, which is phasing out the listed treatments to reduce costs, the list appears in a health briefing by the Audit Commission that encourages other Trusts to follow Croydon’s example.
The Medical Technology Group (MTG), a leading coalition of medical device companies, patient groups and research charities, has argued that ruling out medically important procedures in this way will damage patient care, while achieving only marginal savings to the NHS as many patients unable to access these treatments will deteriorate, requiring higher-cost interventions and reducing their independence and ability to work.
The MTG also noted that the list and its implementation run counter to the Government’s declared NHS policy of putting decision-making into the hands of local clinicians and patients.
Barbara Harpham, Chairman of the MTG and Director at Heart Research UK, commented that the Audit Commission list was not endorsed by NICE, doctors or patients. “This is an un-evidenced and damaging study which will do nothing for patient care, nor NHS finances,” she said.
“Procedures should be agreed following a discussion between patient and doctor, based on the best available evidence of clinical and cost effectiveness. Issuing arbitrary and indiscriminate lists which ignore individual needs is the antithesis of good cost saving and exactly what the NHS should avoid.”