Dear Further to your request under the Freedom of Information Act 2000, I am now in a position to respond.
1. Please confirm or deny whether you commission services relating to the management of the following symptoms of multiple sclerosis (MS):
NHS MK - We commission MS services without specifying the detailed symptoms.
NHS Northants - These conditions are commissioned irrespective of whether the patient has MS. There
wil be a pathway/criteria for treatment and patients wil be treated accordingly.
2. If Question 1 a) – i) is confirmed, please provide details of the services you commission for managing the symptoms of MS listed above, including: (i) What pathways/ guidance are followed; (ii) what type of setting the services are provided in; (iii) how the services are staffed; (iv) the range of treatments offered to patients; (v) how patients can be referred to the services; (vi) whether quality of life data is taken into consideration; (vii) whether data demonstrating a reduction in hospital admissions and consultations are taken into consideration; (viii) whether data demonstrating a reduction in social care costs are taken into consideration
NHS MK - Decisions on treatment options are made by the clinician. NICE guidance and other national guidance and other national guidance adhered to. Community settings – the person’s own home or other appropriate community setting as required. Also out patient settings at BCH and in Oxford. We have 1.6 WTE clinical specialists and patients are also referred as required for rehab to the Neuro Rehab service which is a multi disciplinary team of Physio, Occupational Therapy, Speech and Language Therapy, Nursing and Psychology with visiting Neuro Rehab Consultant and Neuro Psychiatrist. Medication treatment in the form of Disease Modifying Medications are overseen by our Clinical Nurse Specialist. Rehab treatment is available for the Neuro Rehab Service. Clinical Specialists provide advice, support and information and refer on to other services as required. Spasticity management is available locally at BCH, contract is with Oxford. Referrals come from clinical and social care professionals; as well as self referrals from people over 18 with an MK GP. Clinical Specialists
collect data regarding the number of hospital admissions avoided due to their input. MKCHS providers do not collect data on the reduction of social care costs. NHS Northants - Decisions on treatment options are made by the clinician. 3. Please confirm if the following are included in the MS-associated spasticity drug treatment pathway
i) Intramuscular botulinum toxin no (NHS Northants)
j) Intrathecal baclofen is funded for severe spasticityb (NHS Northants)
NHS MK - These drugs are available according to needs of patient as assessed by the responsible clinician.
4. If any treatment in Question 3 a) – k) is not included, please confirm on what basis this decision was made
NHS Northants -Sativex is not commissioned across the East Midlands on the basis of weak evidence and high cost. It does not achieve the cost effectiveness threshold to make it affordable to the NHS.
Fampyra is not commissioned across the East Midlands on the basis of weak evidence and high cost. It does not achieve the cost effectiveness threshold to make it affordable to the NHS.
5. Please confirm or deny whether any treatments to manage the symptoms of MS are currently classified as “low priority”, blacklisted or otherwise non-funded, in the PCT’s prescribing policies
6. If Question 5 is confirmed, please provide a list of the treatments that are currently classified as “low priority”, blacklisted or otherwise non-funded, and on what basis that classification was made
NHS MK - Sativex is low priority. Fampyra is non-formulary - no requests made for it yet.
7. Please provide details of your PCT’s policy for determining access to “low priority”, blacklisted or otherwise non-funded, treatments
Please see attached policy for MK & Northants. (Please contactfor attachment, quoting JH/FOI/08790)
a) how many individual funding requests have been submitted by people with MS for any treatments classified as “low priority”, blacklisted or otherwise non-funded, by the PCT, broken down by treatment, for the last three financial years
b) how many of these requests have been successful and how many have been unsuccessful, broken down by treatment, for the last three financial years
Please note that in line with section 40 (2) (Personal Information) of the Freedom of Information Act 2000, we are unable to disclose actual numbers as doing so may lead to the identification of patients.
9. Please confirm or deny whether your PCT has received any representations from individuals or organisations regarding access to treatments to manage the symptoms of MS in the last three financial years
It is not thought so, however it is not possible to answer on behalf on every member of staff who may have been contacted.
10. If Question 9 is confirmed, please list the name of the organisation and the date on which the representation was made
11. Does your PCT always take into consideration any patient access schemes offered by manufacturers in deciding whether or not to fund specific drug therapies?
NHS Northants Yes, although these are not always sufficiently transparent to help with the local decision-making process NHS MK - Yes
I trust you find this information useful. Please do not hesitate to contact me if you require any further assistance. I have attached a copy of the Trust’s leaflet on how we deal with Freedom of Information requests, should you require any additional information about the process. Please note that any re-use of this information wil be subject to the ‘Re-use of Public sector Information regulations.’ Please contact the Freedom of Information Officer for further information. Kind regards,
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