The decision to restrict the heart drugs was last night attacked by health watchdogs, who said wider prescribing of the medication had been recommended to stop “lives being destroyed”.
The restrictions emerged amid growing concern about rationing across the NHS, with increasing limits on surgery for cataracts, and hip and knee operations, as the health service faces the worst financial crisis in its history.
NHS trusts are expected to announce that they are missing a swathe of performance targets, with long waits in Accident & Emergency (A&E) departments, even in the height of summer, and delays for cancer treatment.
On Wednesday a leading surgeon raised fears that growing numbers of patients will be left to endure “crippling pain” amid tightening restrictions on common treatments and operations.
It followed the emergence of plans from St Helens clinical commissioning group (CCG) in Merseyside to suspend all but the most urgent treatment for four months, in a bid to stave off a cash crisis.
Now a second NHS organisation, also in the north west, has come under fire over a decision to ration some of the cheapest treatments.
The National Institute of Health and Care Excellence (Nice) recommends statins should be offered to all patients assessed as having at least a one-in-10 chance of suffering a heart attack or stroke within a decade.
The cholesterol-busting drugs cost the NHS less than 10 pence per patient per day.
But Stockport CCG has caused fury from senior doctors and from Nice, after ordering local GPs to ignore the Nice advice, instead restricting the drugs to those at greatest risk.
Dr Andrew Green, chairman of a British Medical Association committee on prescribing, told Pulse magazine: “So many CCGs are in deficit due to under-funding, and the pressure on them to achieve financial balance is so great that we are beginning to see some very strange decisions born out of desperation.”
The CCG said the decision to restrict the drugs to those with at least a one-in-five chance of heart disease was part of a wider strategy to tackle its finances.
In a statement it said: "The CCG was required to make some decisions on savings to achieve financial balance and long-term financial health. The plan included a decision to not implement the NICE lipid modification guidelines for primary prevention in full.”
Professor Mark Baker, director of the centre for clinical practice at Nice, criticised the CCG’s decision.
He said: “Cardiovascular disease maims and kills people through coronary heart disease, peripheral arterial disease and stroke. Together, these kill one in three of us. This decision amounts to denying patients access to the most effective means of reducing that risk.”
He said there was an “overwhelming body of evidence” to support their recommendation in 2014 to prescribe the drugs more widely.
“Our guidance is intended to prevent many lives being destroyed and it offers a major shift in public health outcomes at relatively low cost,” said Prof Baker.
He said patients at risk of heart disease should be able to take the decision about whether or not to go on the medication, and not be denied the choice.
It said those with lower risks were advised to make lifestyle changes. Those who refused to do this would be “considered” for statins, the CCG said.
In a statement, the CCG said: "For the majority of people, the most effective way to reduce the risk of a heart attack or stroke is to make lifestyle changes which can include changing diet, increasing activity, lowering alcohol consumption and stopping smoking. These changes also have other health benefits including reducing your cancer risk."
A Department of Health spokesperson said: "Doctors should make decisions about prescribing statins based on clinical evidence - there should be no blanket restrictions.
"We are giving the NHS more money - £4 billion this year - to fund its own plan for the future, and it's vital that money is spent effectively."
On Wednesday Stephen Cannon, vice-president of the Royal College of Surgeons, raised concerns that patients could be left waiting years for hospital treatment without major changes in NHS funding.
He issued the warning as NHS managers at University Lincolnshire Hospitals NHS trust discussed proposals to close Grantham and District’s A&E department at night after reaching "crisis point".
The trust said it had become "seriously affected" by a "national shortage of appropriately trained doctors to work in A&Es".
Statins are the least of the financial problems the NHS is facing, those who have to pay for their prescriptions now at £8.40 will be more than covering the costs
Graham
1 comment:
that's good news in fact as it will mean less inappropriate prescribing of statins
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