Patients with terminal illnesses will be granted much greater access to life-extending drugs on the NHS in order to avoid them having to pay privately for their care, the Government promised today.

The NHS watchdog that decides the cost effectiveness of new medicines has been asked to place greater value on drugs that are not currently considered worth supplying on the NHS, but which could provide the only chance of extra months or years of life for those with incurable conditions such as cancer.

Ministers also announced that, from today, NHS trusts should not withdraw treatment from patients who choose to pay privately for the latest medicines not yet approved by the National Institute for health and Clinical Excellence, which assesses the cost-effectiveness of NHS treatments in England and Wales.

The landmark review published today by Professor Mike Richards, the national clinical director for cancer, recommends a package of measures designed to substantially improve access to medicines on the health service and reduce the need fo patients to resort to private treatment.

It must always clear that people are being treated as either a private or an NHS patient, by providing separate care in different locations or hospitals, he added.

The Department of Health also issued new guidelines to encourage “greater flexibility” when NICE appraises high-cost drugs designed to help those with severe illness.

This could see the watchdog reassess its recent draft guidance which rejected a new class of drugs for kidney cancer as too expensive, to the dismay of doctors and patient groups.

Under the new measures, NICE’s independent appraisal committees are asked to give particular consideration to treatments for rare conditions which affect 7,000 patients or less, and for whom the average life expectancy is not more than two years.

This would include incurable conditions such as motor neuron disease as well as less common forms of cancer, Sir Michael Rawlins, NICE’s chairman, said.

By next year, the watchdog should be releasing its guidance on the majority of new medicines within three months of them being licensed for use in the UK, he added.

Professor Richards said that patients should only need to pay for treatments awaiting approval by NICE or that had been rejected or subject to conditions by the watchdog.

Doctors “should satisfy themselves that all reasonable avenues for securing NHS funding have been exhausted before a patient has to consider additional private drugs,” he said.

The Government’s efforts to speed up the NICE process and encourage the pharmaceutical industry to offer discount schemes for some medicines would “massively” reduce the number of patients who would need to pay for drugs, he added.

When NICE has yet to approve a treatment the NHS can choose to fund the drugs if patients can persuade local health authorities that they are an exceptional case.

But a survey of NHS trusts for today’s review showed estimated that 15,000 patients in England appealed to local committees for funding in this way last year.

Some patients who opted to pay for drugs privately were told they must pay for all subsequent NHS services, such as blood tests and scans.

Although at least 30 hospitals have decided to previously ignore this sanction, the prospect of privately-funded "top-ups" for NHS care is said to contradict a founding principle of the NHS as “free at the point of need” for every taxpayer.

But Professor Richards concluded that where people did choose to pay, “it is important that these patients are not penalised for this choice.”

But he added that when private treatment was sought in combination with their NHS treatments, these should occur in separate hospitals or facilities, as when patients currently opt for private medical insurance or other treatments.

Presenting the report to the House of Commons, the Health Secretary, Alan Johnson, said that he accepted Professor Richards’ recommendations in full.

“The measures set out, together with the improvements proposed by NICE, mean that a greater range of more expensive therapies will be available to more patients on the NHS — reducing the need for them to seek private care," he said. “A small number of patients may still choose to pay for additional drugs not available on the NHS. But I have agreed that, from today, NHS care must never be withdrawn in these cases — as long as private treatment takes place in a private facility.

"Patients and the public can be confident that from today, there will be greater clarity, greater fairness and, most importantly, greater access to a wider range of drugs.”

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