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GP commissioners should have national ‘do not do’ list, says think tank

Clinical commissioning groups (CCGs) should be given a national list of treatments to decommission based on NICE advice, a new report recommends.

The national list of ‘do not do’ treatments should be drawn up and policed by the NHS Commissioning Board with treatments on the list only available in exceptional circumstances, says the report from health think tank the Nuffield Trust.

The report, ‘Rationing health care: Is it time to set out more clearly what is funded by the NHS?’ says CCGs should report publicly on their progress in following the advice and explain any exceptions where such procedures are funded.

It recommends against explicit national rationing in the NHS but calls on the new NHS Commissioning Board to use NICE guidelines to draw up a national list of what is, and what isn’t, available on the NHS.

The report says: ‘Local clinical commissioning groups should be required to report publicly on their progress in following this “do not do” advice, explaining any exceptions where such procedures are funded.’

‘More generally, clinical commissioning groups should be expected to report on departures from national guidance.’

The report comes after Pulse revealed the Government was planning a wide-ranging ‘compliance regime’ to ensure all NICE-approved treatments were available across the country.

The report was released along with a survey showing four out of five GPs believe the financial challenge facing the NHS will force the Government to explicitly ration health care.

The survey of 821 GPs in England showed 85% of GPs thought the Government would have to set out more clearly what care is – and is not – freely available on the NHS.

Dr Judith Smith, Nuffield Trust head of policy said: ‘The current system for defining what is in and out of the NHS “offer” is far from ideal.’

‘That’s why the NHS Commissioning Board should work closely with CCGs to ensure they are not deviating from national guidelines about what to fund and what not to fund, unless there are good reasons for doing so, and that any decisions made locally are subject to proper public scrutiny.’