Thursday, 5 July 2018

NHS@70: postcode prescribing and doing something about it

Today is the NHS' 70th Birthday. Happy Birthday we love you! 



We know you are the best value for money health service in the world and that you try your best with limited resources. We want to pledge our support for you and help you make the next 70 years even better. 


At your heart you espouse several principles that are worth remembering and fighting for: 

1. Healthcare is a basic human right
2. Healthcare should be equitable; no matter who you are you should have access to the same level of care
3. Healthcare should be free at the point of access. 

We know your principles are being eroded and people with MS (pwMS) have highly variable access to care across the UK. Variance in MS Services, for example, access to and the prescribing of disease-modifying therapies, have been well documented by the MS Society, MS Trust and the Royal College of Physicians. This has been backed up by new data presented at the recent ABN meeting in Birmingham from the NHS England's Bluteq database. 

We and others feel this is a problem for pwMS and is a barrier to improving MS outcomes. To address this problem we are holding a meeting of representatives from MS DMT prescribing centres across England and the UK. The aim of the meeting is to generate ideas and proposals to address and solve this problem. We envisage holding subsequent follow-on meetings to implement and test potential proposals developed as a result of this meeting. 

We have included the draft programme for discussion. If you have any suggestions please feel free to comment. Thank you. 



You can register for the meeting online. Please note that this is a closed meeting and due to limited resources we are limiting attendance to representatives from MS prescribing centres in the UK. Each centre can only send a maximum of 2 representatives. 

25 comments:

  1. Happy Birthday NHS. This is a very ambitious and much needed initiative. I hope you achieve what you are setting out to do. But I suspect the postcode lottery is about money and limited resources.

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  2. Well done for putting this together. I admire your energy and enthusiasm for your specialty. The MS community appreciates what you do for people living with this awful disease.

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  3. Happy Birthday

    I suspect until low cost generics arrive, and NICE are around the post code lottery will continue to be a problem...Maybe we should follow Sweden as role models and prescribe off-label.

    Increasing income tax may not be a bad idea if it was ring fenced. If we want it we need to pay for it.

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    1. The Swedish model may not address the problem. Prescribing off-label has apparently resulted in their MS DMT budget being cut and hence they now have difficulty increasing it again for newer agents and other initiatives. In other words saving on MS DMT by off-label prescribing does not necessarily mean you can direct the savings to MS services. The DMT budget is held by NHS England and the budget for MS services on the ground by local commissioners.

      We are therefore going to have to be creative about the solutions we come up with.

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  4. Why don't you charge to attend this meeting and open it up to more people with MS and their carers. I suspect they will have a lot to say and may even contribute to the meeting.

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    1. Good idea, but the cost and size of the venue is also a limiting factor. We could look into broadcasting the meeting live or recording the talks and putting them online after the event.

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    2. It would certainly be useful if those of us who cant attend or dont qualify can see some of the material presented - even if only the closing sessions and summaries

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    3. It would certainly be useful if at least the closing summaries and slide presentations could be made available, if not full recordings. I think a lot of people who won't be in attendance will be very interested in the discussions and presentations.

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  5. The NHS is like a black hole it simply sucks in money and the bigger it gets the more money it needs. I would suggest breaking it up into mini-NHS's and to let them compete with each other. Nothing like a market to sort out inefficiencies and to drive up the quality of NHS care.

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  6. Or privetize it altogether. America has such a great health care system, market on its best.

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    1. I agree the NHS should be privatised, but spelt with a $ and a Z.

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    2. No, no, no; please keep the capitalists away from our precious NHS.

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    3. Noooooooo. To privatize would be a total disaster. Look at PIP assessments. Cariiion

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    4. The comment was meant to be ironic, America has a monstrous health care system. No need to make assumptions on how bad private health care can be, we have already seen it.

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  7. "The collective principle asserts that... no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means."
    Aneurin Bevan, the founder of the NHS, a fellow Welshman and political hero of mine.

    Happy 70th NHS!

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    1. Homie, Bevan resigned after 1951 because of the introduction of waiting lists to mitigate the ballooning demands on our NHS. The NHS never recovered after that point.

      So cool to see Don Giovannoni wax lyrical about my beloved NHS, because his posse at the BMA tried to kill it before its inception. Doctors wanted MONEY! baby, and lots of it. My homeboy Attlee 'shoved their mouths with gold' to get 'em on board. Even now they go on strike over wanting more De Niros even though they get six-figure salaries. Doctors are the scourge of our NHS and are killing it from the inside out. Look how the BMA defended Dr. John Bodkin Adams, and continues to protect venal practitioners despite blatant malpractice.

      Much love to you nurses, porters, pharmacists, cleaners, physiotherapists, OTs, cooks and assistants. No lurve to you money-hungry doctor losers.

      Bredrin, it's been a long time (long time), we shouldn't of left you (left you),
      Without a dope beat to step to (step to, step to, step to, step to)...

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    2. Always lovely to hear from our professional contrarian.

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    3. Dre! Where have you beeeeeeeen!?!

      I love you, man. So good to hear from you. You make me smile with the stuff you say. It's so British and tongue-n-cheek. Love the wittiness of you Brits.

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    4. Dre It takes many talents to make the NHS work well. Not sure the NHS could run without its Doctors. Not all are money-hungry losers.

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    5. Yay, homie Dre is back.

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    6. Get real - reduce doctor's and consultants salaries and they will end up leaving into pharma and other jobs and then who will you have to make the decisions and follow the current research? As good as NHS porter and nurses are, they have their place in the organisation. Compare doctors and consultants salaries with senior posts in industry that have also lengthy training histories for professional qualifications - nhs tends to be lower and lacks the perks (e.g. annual bonuses, share options, company car, [and ironically for this conversation] private healthcare). Hospitals have enough problems attracting and retaining suitable staff without attitudes like this. If you don't like the NHS, take on private healthcare and remove yourself from the system, or emigrate to the US where you can pay for what you like (assuming you have the funds). Whinging about it pointless especially on a blog such as this that is being proactive and seeking ways to make a real difference in preventing and treating MS. You won't see actions and commitment like this from US doctors on massive salaries in "pay for treatment" private roles......

      Prof G and team - no matter how much they are paying you, its not enough; your weekend and out of hours posts are noticed and appreciated especially as you have your daytime jobs on top of this blog.

      Signed: One of many anonymous Barts blog and staff supporters

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    7. It's just Dre being hilarious. He is just being himself, anon 12.20. He's like that.

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  8. A very exciting programme. I wish I could attend. Sadly I someone with MS who wishes they had more access to healthcare.

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  9. Three score and ten! It's lucky to be alive. Now is the time to think of an NHS succession plan

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