Our second policy briefing in the run up to the General Election 2015 provides an overview of the current difficulties in making decisions about rationing healthcare in England, and sets out some of the challenges faced by policy makers in the future.
The rationing process in the NHS is messy. Policymakers, commissioners and clinicians have muddled through and have made a series of compromises and trade-offs. This has resulted in reduced access to treatments in some areas for reasons that have not been made clear and it has led to cancer drugs receiving priority over other treatments at a national level. Nigel Edwards, Nuffield Trust Chief Executive and lead author
The briefing argues that despite the lack of public support for rationing decisions, there is room to improve the level of transparency in the system. It suggests a greater use of public consultation and better communication about local commissioning decisions. The briefing commends the approach of the National Institute for Clinical Excellence (NICE) in appraising new technologies and says that NICE should be given responsibility for decisions about expensive cancer drugs currently considered under the Cancer Drugs Fund.
Alongside our policy briefings, we are also regularly surveying a panel of 100 health and social care leaders in England for their views on a range of issues, including the state of the NHS and social care system, and what they believe should be the priority areas for reform during the next Parliament. The latest survey finds that over a third of respondents felt that the current approach to rationing healthcare was unfair and 7 in 10 said that the Cancer Drugs Fund should be wound up.
Edwards N, Crump H and Dayan M (2015) Rationing in the NHS. Briefing. Nuffield Trust.