Greater rationing role predicted for NICE

NHS policy Officials suggest that NICE's remit could further expand to govern all NHS rationing decisions.

Gillian Leng
Gillian Leng

NICE's role could expand to effectively controlling all NHS rationing decisions, according to one of its top officials.

Dr Gillian Leng, deputy chief executive of NICE, told a Westminster Health Forum event in London last week that it could play a bigger role in controlling resources as the NHS's finances worsen.

NICE currently calculates the cost-effectiveness of drugs and technology and issues guidance on the best clinical treatments.

Its role was expanded following Lord Darzi's 2008 NHS review to cover setting QOF indicators and quality standards for clinical pathways.

But Dr Leng told delegates that NICE could highlight saving opportunities for commissioners, and even 'identify areas of healthcare where activity could be reduced or stopped'.

Former Labour health minister Lord Warner agreed that NICE's 'cost-benefit approach' seemed likely to be used across a broader area of the NHS.

Dr Leng also said the NICE cost-effectiveness threshold, which determines which treatments the NHS will fund, would be regularly reviewed.

Dr David Jenner, NHS Alliance GMS contract lead, said NICE was well placed to make such decisions. 'NICE is well constituted to make decisions about what the NHS can afford to provide and take it out of the hands of politicians.'

An expanded NICE would allow primary care organisations to 'balance the books' without being derided locally for cutting services, said Dr Jenner.

'If the public don't want taxes to rise and want public services to be trimmed back, who is better placed to make those decisions?' he asked.


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