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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.’