2. Background
• The Nuffield Trust, an independent health think tank, and
Doctors.net.uk, the largest online professional network of doctors,
have conducted a survey of GPs in England to test opinion on
whether – given the financial challenge facing the NHS – they
believe the NHS will have to further restrict what is, and what is not,
available to patients free at the point of use.
• The survey has been timed to coincide with the publication of a new
Nuffield Trust report: Rationing health care: Is it time to specify
more clearly what is funded by the NHS? The report examines the
feasibility as well as advantages and disadvantages of setting out
explicitly the limits to the care patients are entitled to.
3. Methodology
• The survey conducted by the Nuffield Trust and Doctors.net.uk –
known as the ‘medeConnect GP omnibus’ – is a regular monthly,
online study of doctors drawn from the Doctors.net.uk community.
• A regionally representative sample of 1,009 UK GPs took part in
the survey – of which 821 are practising in the NHS in England. As
the issues raised in the survey are most pertinent to the English
NHS, all results included in this slideshow relate to the 821 GPs in
England alone.
• The February 2012 omnibus ran from the 15 to 21 February.
10. Q1. In the next 5 years the NHS will have to set out more clearly
what is – and what is not – available to patients free at the point
of use on the NHS.
11. Q2. Over the next five years the NHS can be made more efficient so that
the services funded by the NHS free at the point of use are not curtailed
more than they are at present.
12. Q3. Making clinical commissioning groups (CCGs) responsible for setting
priorities for spending NHS funds is likely to lead to greater variations in what
services are provided to patients throughout the NHS in England.
13. Q4. Who do you think should be responsible for ultimately deciding
which services should – and should not be – funded and available to
patients free at the point of use in the NHS in England?
15. Rationing health care: Is it time to specify more clearly what
is funded by the NHS?
• The Nuffield Trust report draws out learning for the NHS from
countries that have sought to set out explicitly the health care
benefits that are paid for by their publicly funded health system.
• It outlines a range of problems with the current system for
determining which treatments are, and are not, funded by the
NHS. These include: a lack of transparency around how
spending decisions are made and variations in funding
decisions.
• The report stops short of recommending the Government
draws up an explicit account of what health care is and what is
not funded, ruling it out on the grounds that it would risk
compromising the principle of solidarity on which the NHS
relies.
16. Continued…
However, the report makes several recommendations for how the
system could be improved so that, among other things,
perceptions of unfairness could be avoided. These include:
• Establishing a set of principles that would shape how public
money is spent in the NHS;
• Producing a national list of the treatments that public money
should not be spent on in the NHS;
• Ensuring decisions in CCGs are transparent and clinicians are
‘nudged’ towards clinical and cost effective care.
The report is available to download from
www.nuffieldtrust.org.uk/publications/rationing-health-care
