PCTs Beware — NICE Compliance Regime Plans Are Here to Stay

If Primary Care Trust (PCT) managers in the United Kingdom were a bit worried about government plans for the introduction of a NICE Compliance Regime last month, they should certainly be panicking now. Last week Health Secretary Andrew Lansley told MPs that the plans – first mentioned by Prime Minister David Cameron in December – are not going away.

Last month I examined what the introduction of a NICE Compliance regime will mean to cash-strapped, but the new statements call for the issue to be revisited.

What is New?
In response to a question from Labour MP John Healey, the Health Secretary said last week that existing legislation was clear, but had not always been followed through. “What we will do, and the NHS chief executive is setting out to do, is to show how that will happen in the future,” Lansley announced.

The response clearly refers to the fact that NICE guidance is already meant to be mandatory. Under existing regulations, PCTs have 3 months to start funding NICE-endorsed drugs from the date NICE issues a positive guidance. I previously mentioned that PCTs often fail to adhere to this legal requirement and “blacklist” NICE-endorsed drugs – thus, banning doctors from prescribing them. The practice – known rather infamously as “the postcode lottery” in access to treatment – has been rampant under Labour.

But what can the Coalition government do to end the practice if regulations are already clear but are not being followed through?

A true end to the healthcare postcode lottery?
It will be many months before the details of what the Health Secretary and the NHS Chief Executive are planning become publicly available. A change in regulations may or may not come as a result of these plans. What we would definitely expect to see, however, is a change in the way regulations are enforced.

Enforcement that would end the postcode lottery sounds like an admirable goal. Achieving this goal would provide a government embattled over its healthcare reform plans with the opportunity to take credit for at least one thing – close to the hearts of patients and physicians – that has been done right. Not to mention getting one up on Labour before the next elections.

Details on enforcement action may remain murky for months to come, but there is little doubt in my mind that once they emerge, the full strength of Britain’s coalition government will be thrown into ensuring they are speedily approved and imposed onto PCTs.

“We ended the postcode lottery” would be a great selling point in the next general election after all.