Gulf between health and social care holding back transformation
On the eve of the National Health Service’s 70th birthday, the UK government spending watchdog has warned that funding problems and a gulf between health and social care is holding back progress.
The National Audit Office (NAO) has today published a report assessing the challenges preventing health and social care from working together effectively, and says it wants to encourage the government to create a long-term plan for a sustainable, joined-up care sector. This is in line with NHS England’s plan to create Integrated Care Organisations to provide seamless services to patients. The head of the NAO, Amyas Morse (pictured) says faster progress is needed towards a service that centres on the needs of individuals, meets growing demands for care and delivers value to the taxpayer.
The report reveals that stretched funding has sometimes seen health losing budget allocation to social care, or the reverse, while different ways of working and problems in sharing data remain as substantial barriers to integrated care.
“No one across government or the civil service would disagree that health and social care have to be in balance to give people quality of life, and to use the available national and local resources as efficiently as possible. The hard part is agreeing how that balance is to be achieved and maintained, and who is willing to sacrifice what to bring it about,” comments Amyas Morse.
“The NHS did not like funds being syphoned off through the better care fund, whilst local government has reservations about sacrificing over half of its financial resources towards NHS England’s priorities, which risks eroding local democracy. The answer may lie in local flexibility, but that could leave serious gaps in delivering what is needed – an integrated service. Serious political leadership is needed.”
Read the full NAO report here: The health and social care interface
NICE confirms ‘no’ for Opdivo in bladder cancer
England’s cost effectiveness watchdog has published its final guidance on BMS’ Opdivo for treatment of bladder cancer, rejecting its use on the NHS.
This is a major setback for BMS in England, as its main immunotherapy rival, MSD’s Keytruda was approved in the same indication in April.
NICE said Opdivo could not be used in patients with advanced, unresectable or metastatic urothelial cancer after platinum-containing chemotherapy because of lack of clinical and cost effectiveness data compared to current treatments.
NICE says that because neither data collection from clinical practice or the ongoing trials would resolve the identified uncertainty, Opdivo was not suitable for use within the Cancer Drugs Fund for these patients.
Read the full NICE recommendation here
Expanded use of Xalkori approved in England
Also released today was final NICE guidance recommending Pfizer’s Xalkori (crizotinib) to treat ROS1-positive advanced non-small-cell lung cancer (NSCLC).
It is already approved for patients with ALK positive NSCLC.
The drug will only be available through the Cancer Drugs Fund (CDF) for these patients, however. This means more evidence on the targeted cancer treatment is being collected until April 2023, at the latest). After this NICE will decide whether or not to recommend it for use and update the guidance.
Xalkori is for now keeping one step ahead of rival treatments, such as Novartis’ Zykadia, which gained NICE approval for use in ALK+ patients in January, and Roche’s Alecensa, which just gained NICE approval in this setting last month.
View NICE’s appraisals of Xalkori here