Hot on the heels of the Health and Social Care Act 2012, the National Prescribing Centre (NPC), now part of NICE, has published a Local Decision-Making (LDM) Competency Framework commissioned by the DH to support 'groups' (in reality CCGs in their current shadow form) involved in making local decisions about the funding of medicines and treatments in the NHS.
Building on its long-standing role for providing such support there is a whole LDM section on the NPC website with some really useful resources the Framework is designed to maximise consistency in LDM processes across the NHS. Wherever a drug or intervention has not received a positive technology appraisal from NICE commissioners will have to set local priorities for healthcare investment and resource allocation and then consider individual applications to access non-routinely funded treatments on an exceptional basis.
The NHS Constitution (recently revised) reminds us that patients have the right to expect local decisions on the funding of non-NICE-approved drugs and treatments 'to be made rationally following a proper consideration of the evidence'. If every CCG made decisions on a different basis it is self-evident that the potential for an enduring postcode lottery in the NHS is immense.
Throw into the mix the involvement and engagement of patients and anyone taking their first steps in the world of prioritisation will obviously need a clear road map. The Framework is designed to support decision-makers to perform their duties effectively acting as both a training resource and a tool for reflective practice. It breaks each of the nine identified competencies down into a series of specific skills with underpinning abilities and knowledge required.
And just in case you still aren't convinced it may reassure you to know that the Framework comes with the authority of many of the glitterati in the priorities field - check out the membership of the steering and working groups at Appendix 2!