NICE should offer decommissioning advice, Audit Commission says

NICE should help commissioners identify treatments of low clinical value from which funding can be withdrawn, an Audit Commission report has concluded.

Up to £500m a year could be saved if the NHS in England reduced its use of low clinical value treatments, according to estimates in the report. This money could then be spent on more clinically effective treatments, it said.

The Audit Commission has produced a tool to allow commissioners to calculate the savings that might be achievable in their area. It is available at

Commissioners in GP consortia will be better placed those PCT have been to cut services, the Audit Commission said.

‘This will become simpler when GP consortia are created and become responsible for commissioning services for their patients,’ it said.

‘They will be able to decide themselves the treatments they will and will not commission.’

At present, commissioners are duplicating efforts by each creating their own lists of treatments of low clinical value, the report said.

‘All the PCTs we spoke to were keen to have quality, pooled evidence as a tool to support local decisions,’ it said.

‘It is surprising that NICE has not produced this, given that it is responsible for several of the different lists.

‘Many of the people we spoke to suggested that NICE would be the ideal body to champion decommissioning and to provide a single evidence base.’

NICE deputy chief executive Dr Gillian Leng said the institute had, over past few years, raised the prominence of its ‘recommendations that direct the NHS away from less effective practice’.

‘In focusing on identifying those interventions where there is a lack of evidence of efficacy, or evidence of a lack of efficacy, NICE aims to provide a useful resource that will help the NHS realise significant savings,’ she said.

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