This has always been an interpretation of NICE that I don’t understand and perhaps NICE does not understand either.
What I do understand is that there is a requirement to provide appropriate funding and resourcing for a NICE approved technology within three months or 90 days. This is a statutory requirement also underpinned by the NHS constitution. Just has to be done – no question. And the 90 days helps when resources need to be found (although PCTs and CCGs should plan for this) and resources to support implementation put in place.
What I don’t understand is why NICE says that medicines with a positive nice technology appraisal (where did this term ‘positive’ come from?) should be included into the local formulary automatically – and then add the line ‘within 90 days’. I am sorry but my definition of automatically is not within 90 days.
We are further instructed not to duplicate evidence assessment or challenge an appraisal recommendation so why the delay? If we have nothing to discuss with reference to the formulary then what are we doing that takes 90 days?
I am pleased that there is some clarity around if clinically appropriate is now attached to relevant to the service. It should always have been obvious that, for example a mental health trust probably doesn’t need to list cancer drugs in their formulary. I have heard colleagues suggest that they consider that some decisions are not clinically appropriate in their area. Not relevant to their service – maybe – but not because NICE decisions are not clinically appropriate.
As I said, I don’t understand. If you want a simple solution well within 90 days with automaticity automatically included – contact Richard at the MMP – firstname.lastname@example.org