NHS Hull Clinical Commissioning Group (CCG) and East Riding of Yorkshire CCG recently undertook a clinical review of patients who are receiving infusion therapy of either Lidocaine or Phenytoin for the treatment of chronic pain. This treatment is currently being received by 40 Hull patients and 46 East Riding patients and is delivered at the Spire Hospital in Anlaby.
The National Institute for Health and Care Excellence (NICE) has never recommended infusion therapy for the treatment of chronic pain and there is limited evidence to support the use of recurrent infusion therapy in treating chronic pain. There are also a number of potential side effects.
For these reasons, infusion therapy for chronic pain has not been routinely commissioned by NHS Hull CCG and East Riding of Yorkshire CCG and this treatment was only approved via an Individual Funding Request (IFR) where a panel reviews requests for this treatment and only approves the treatment in exceptional clinical circumstances.
Hull CCG held an extraordinary IFR panel on the 19th December 2017 and East Riding CCG on 5 October 2017 to undertake a full clinical review of these patients. In making its decision, each IFR Panel considered the clinical evidence and the plan for managing each patient. In the cases reviewed, both IFR Panels, led by clinicians, did not consider clinical exceptionality in the majority of the cases and therefore did not feel able to continue to approve a treatment indefinitely that has little clinical evidence base to support it.
Both CCGs are aware that some of these patients have been receiving infusion therapy treatment for some time and are making arrangements for a clinical review to be undertaken by specialist pain management services with each patient and to put a plan in place that will best meet each patient’s longer-term pain management needs. Until these reviews are undertaken the majority of patients will receive one infusion every 12 weeks, until the end of January 2019 or until alternative treatment plans are agreed.
If patients have any concerns they should, in the first instance, discuss these with their consultant or GP. Alternatively they can contact Hull CCG’s Patient Relations Team on 01482 335409, email HULLCCG.PALS@nhs.net or East Riding of Yorkshire Patient Relations Team on 01482 672047, email ERYCCG.ComplaintsAndConcerns@nhs.net