Postcode Lottery

A recent report published in Healthcare Insurance Magazine shows that where you live in the country could mean the difference between you receiving life prolonging treatment or not.

The research shows that each of the 152 Primary Care Trusts in England has its own Regulations for interpreting the Governments National Institute for Health and Clinical Excellence (NICE) guidelines when deciding whether or not to fund treatment for Cancer drugs.

Where a PCT initially refuses to fund a drug or treatment patients are allowed to appeal to the “Exceptional Case Panel”. The Exceptional Case Panel reviews the PCT’s decision and gives a final answer as to whether or not the drug or treatment will be funded.

If you live in Manchester, Salford, The Wirral, or Torbay the Exceptional Case Panel is very likely to grant your request for treatment whereas if you live in North Tyneside, Nottinghamshire, Shropshire or Bath and North East Somerset it is unlikely that the Exceptional Case Review Panel will grant your request. Only 7% of cases going to the Exceptional Case Review Panel in Kingston resulted in funding for the treatment or drug.

At MPH we have also found huge variation where the PCTs will funding treatment or drugs between neighbouring PCTs. This means that a Cancer patient living just one street away from another may be treated totally differently when a request for funding is made.

If the PCT Exceptional Case Panel has turned down your request for drugs then the only option left for you is to consider Judicially Reviewing the PCT. At MPH we have the expertise to deal with Judicial Review Applications for exceptional funding for drugs and treatments. If you think we can help you, you should telephone Oliver Wright on 0161 828 8084.