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GPs should not block personal budgets even if treatments have no evidence, says RCGP

GPs should not block personal health budgets even if patients decide they wish to spend NHS resources on a treatment with no clinical evidence to support it, such as complementary therapies, recommends the RCGP.

In a new guide to GPs, the RCGP said that where there is evidence a treatment could be harmful it should not be approved, but that treatments that are safe, but lack evidence as to whether they work should be considered on a case-by-case basis.

The advice comes despite the college’s demand last year to work with Government on a stricter policy framework, to stop patients using the money on ineffective treatments.

The guide to personal health budgets - available free from the College’s website - advises GPs to consider approving personal health budgets including treatments like hydrotherapy, aromatherapy, reflexology, swimming and dance classes if they feel patients will benefit.

It says: ‘People may want to use their budgets for treatments where there is no clinical evidence to support their use. This should not be automatically prevent approval, as, despite not being supported by clinical trials, a selected treatment may work for an individual.’

It adds: ‘We will need to consider appropriate treatments or services on a case-by-case basis, thinking holistically about the individual and what may or may not work for them.’

The college had warned last year that the scheme could lead to a widening in health inequalities, and the BMA called for a delay in the rollout of personal health budgets as doctors did not know what they are.

The Government confirmed in November that all eligible patients will be given the right to have a personal health budget - and this was confirmed in the coalition’s mid-term report published earlier this week.

This was despite controversial results of the pilots which saw patients purchasing theatre tickets, manicures and complementary therapies.

All patients in England receiving NHS Continuing Healthcare will be eligible for a personal health budget to spend on treatment, with this extended to all those all those with continuing health needs by 2014. CCGs will also have the power to offer them more widely to patients who they feel may benefit.

RCGP chair Professor Clare Gerada said the College would continue to monitor the personal health budget rollout: ‘This new guide is an excellent and easy reference tool for GPs and will help to make sure that personal health budgets are used in the most beneficial way for patients.

‘The College previously published a position statement giving the proposals a “cautious amber” carefully exploring the opportunities and risks involved and will continue to closely monitor the development of personal health budgets.’

Readers' comments (12)

  • I shall do this whilst flower arranging between patients

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  • Rather the money was spent in areas where money restricts usage of certain drugs where there is actual evidence, but maybe not the cost benefit ratio.

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  • Stop reducing the health care budget and then coming up with these ridiculous and wasteful schemes. What next, hobnobs for Strokes?

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  • What utter incoherence. The NHS will now (effectively) happily fund treatments of no known benefit. Well, at least we can get rid of NICE., then we can get rid of practice formularies, and all other cost-containing measures, based on any form of cost-effectiveness. Prescribe what you like guys, it must be better value for money that homeopathy.

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  • Have these muesli eating cardigans at RCGP towers gone completely mad? what next? homeopathy??

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  • What a complete waste of space the RCGPs are. They supposedly pride themselves on bringing academia into General Practice and applying evidence based treatments into practice. Then they backtrack on Complementary Hocus Pocus.

    They couldn't organise a few ginger beers in a shop next to their favourite cardigan and pipe outlet!

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  • Just when I thought the RCGP was starting to come up with sensible policies they come up with this. It is very disappointing in an era of scarce resources they they acquiesce to treatments that are not evidence based.
    Why did we go to medical school and study science if this is the correct approach?

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  • Ulrich Pfeiffer: "..what next? Homeopathy?"

    Exists already on the NHS in Glasgow, London and I think also Bristol.
    In Glasgow has existed for about a century and became integrated into the NHS in 1948.
    Pleasant people and it seems to do some good but really just a very expensive placebo. Main benefit in my view is to lighten slightly our heartsink burden.
    Some links if interested:

    As regards the RCGP decision, presumably they simply value the government's opinion of them more highly than clinical evidence or working GPs. Not much chance of getting in the New Year's Honours list otherwise!

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  • Homeopathy in A&E:
    Copy link to browser. Very amusing.

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  • It shows the ture colours of the RCGP. instead of consulting with us, they tell us. I think they need to sit the CSA RCGP exam and I will be more then happy to examine them in the attitudes and behaviour!

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