Friday 09 August 2019
The Committee for Health & Social Care is preparing its proposals to provide a wider range of drugs and treatments with a Technology Appraisal (TA) from the National Institute for Health and Care Excellence (NICE), closing the gap with those available to patients in England through the NHS.
This follows the completion of two reports by Solutions for Public Health (SPH) which consider various options for the adoption of NICE TAs in the Bailiwick and the associated resource implications. The Committee is pleased to publish these reports today, which are available to download from www.gov.gg/NICETA
The Committee for Health & Social Care is now discussing with other committees, namely the Policy & Resources Committee and the Committee for Employment & Social Security, how best to introduce a wider range of NICE TA-approved treatments and how to fund such an expansion, which would incur a significant extra cost.
Out of the 480 currently NICE TA-approved drug and non-drug treatments, 320 are already funded by the Committee for Health & Social Care and 160 are not. The vast majority represent drugs rather than other treatments.
The Committee for Health & Social Care believes the gap between the drugs available in England and those available in the Bailiwick is now unacceptable. Ultimately the Committee wants to move to a position where all NICE TA-approved drugs are available locally. However, practically this is not possible at this stage as it requires increased resources and infrastructure improvements, aside from the significant cost implications of procuring the additional drugs and treatments. For this reason, the Committee is proposing a phased introduction, with the most cost-effective drugs introduced initially, with a review undertaken at the end of the second year of implementation to assess the impact on outcomes.
It is estimated that the additional costs will amount to £5.3m in the first year and £8.1m in the second year. The Committee for Health & Social Care is working with the Policy & Resources Committee to secure the necessary funding for the first two years. However it seems almost certain that a new source of funding would need to be established to continue or expand the provision of NICE TA-approved drugs and treatments beyond this stage.
The funding considerations cannot be made in isolation. Having managed its budget well over the last three years and having delivered real savings to the States of Guernsey, the Committee for Health & Social Care is facing significant budgetary pressures, which are mounting every year as the ageing demographic begins to have a major impact on demand for its services. More resources are needed across the system, including mental health services, community nursing and radiology, to name a few.
'This is one of the most difficult challenges the States faces, and one that will need to be dealt with by both this Assembly and the next. In offering a wider range of drugs and treatments we can help more people, particularly by extending and improving the lives of those with cancer and other serious illnesses. But, it mustn't come at the expense of a reduction, or lack of investment, in other health and care services, including those which focus on prevention and early intervention. There is a clear funding gap in health and care which is only getting bigger and will result in a deterioration of services we can offer unless it is addressed. As I have been saying for a while, a conversation is overdue about whether the community is willing and able to pay for the services it expects and to place health and care on a sustainable footing.' - Deputy Heidi Soulsby, President, Committee for Health & Social Care