Grand designs ignored

Since its inception in April 1999, the U.K.'s National Institute for Clinical Excellence (NICE) has issued more than 250 recommendations as part of its task to advise the National Health Service on treatments and care. Part of the purpose has been to standardize treatment protocols nationwide in order to end so-called "postcode prescribing," under which patients in different regions receive different treatments. However, implementation has been poor, and NICE is making changes designed to ensure that its recommendations are enforced.

In 2001, the U.K. government made NICE guidance on novel drugs and devices mandatory for NHS. Formal recommendations - including allocation of funds - are to be implemented within three months by the regional Strategic Health Authorities (SHAs) and the 300 local Primary Care Trusts (PCTs). But following years in which NHS has been accused by both industry and patient groups of being slow to implement guidances, NICE has now admitted that allegations of postcode prescribing are true and that some PCTs are implementing NICE guidance more slowly than others...