NHS top-up payments to be allowed

The Department of Health (DH) has announced that patients will not lose their entitlement to NHS services if they use their own funds to pay for treatment.

Previously, patients who were forced to pay for drugs that the National Institute for Health and Clinical Excellence (NICE) had refused to supply on the NHS risked losing their entitlement to all NHS services.

Professor Mike Richards, the national clinical director for cancer, carried out the review into these procedures.

The government has recommended that patients be allowed to top-up their treatments. However, under the draft proposal patients will also be expected to pay for staff time and any associated scans and blood tests. Patients who pay for their own treatment will not be permitted to receive that treatment on NHS wards – they must attend either private clinics or private wards in NHS hospitals. 

The Department's proposals will go out to public consultation until January 2009.

Commenting on today's report, Improving Access to Medicines for NHS Patients, Dr Hamish Meldrum, chairman of council at the British Medical Association, said: "It was morally wrong that people who self-funded part of their treatment were denied their right to free NHS care and I have great sympathy for the patients and their families who find themselves facing these terrible dilemmas.

"The key challenge was always going to be to avoid the creation of a two-tier system where some NHS patients receive inferior treatment to others because they cannot afford to 'top-up'. Today's announcement is sensible and outlines useful measures to reduce the likelihood of this happening. The clarity that 'top-up' treatments will ideally need to be properly costed, provided privately and separately from NHS care, and that they will not involve NHS staff, is welcome."

Guidance will be issued to local NHS managers advising on how to deal with individual cases where patients are entitled to make an application for treatment with a drug not normally funded on the NHS.

In addition to the proposed 'top-up' scheme, NICE will be encouraged to be more flexible when looking at the approval of drugs that will be of benefit to a limited number of people (less than 7,000) but will have a significant impact on prolonging their life.

The Welsh and Scottish governments are carrying out their own reviews.