Accessing NHS care and treatment recommended by NICE

Can I still get access to a medicine privately if NICE has not recommended it for use in the NHS?

Yes, NICE's remit is only to decide whether medicines can be made available on the NHS. If NICE do not recommend a medicine for use on the NHS a private company can still chose whether to provide a medicine or not.

How do I get treatment that isn't usually funded on the NHS (an individual funding request)?

Sometimes it is possible to access a treatment despite it not being recommended by NICE for use in the NHS. This can happen if the person treating you believes that your circumstances are exceptional and you may benefit from a treatment or service that is not usually offered by the NHS.

Your healthcare professional can make an individual funding request to NHS England to help you get treatment they think would be suitable for you. NHS England cannot accept individual funding requests directly from patients, although people can work with their health professional to have input.

If you are still unable to get the treatment after trying this option, you and your healthcare professional should discuss what other treatments are available.

NICE has no role in the individual funding request process, so we cannot provide further information about this but NHS England has published a guide for patients.

What is the Cancer Drugs Fund?

Sometimes there is not enough evidence about how well new cancer medicines work. In these situations NICE is unable to recommend that the NHS routinely offers these medicines. When this happens NICE can recommend these drugs can be prescribed through a scheme called the Cancer Drugs Fund. This scheme means that more information about how well the medicines work must be collected. After a few years, once this extra information has been collected NICE will then look again to see if there's enough evidence to recommend it for routine use in the NHS.

You can find out more about the Cancer Drugs Fund on our website.

What is specialised commissioning?

Specialised commissioning is funding to help people access specialist healthcare services. These can involve treatment for rare cancers, genetic disorders or complex conditions. Currently there are 146 specialised services directly commissioned by NHS England.

NICE is currently working with NHS England to help decide which of these specialist services to commission.

ISBN: 978-1-4731-0864-6