An Investigation into an Individual Patient Treatment Request
This report published by Healthcare Improvement Scotland
investigates how an individual patient treatment request (IPTR) was
handled by NHS Ayrshire & Arran.
The investigation was called for by Mr Alex Neil MSP (the Scottish
Government’s Cabinet Secretary for Health and Wellbeing) regarding
how NHS Ayrshire & Arran managed Mrs June Rankin’s clinician’s
request for her to be prescribed the drug Cetuximab for advanced
colorectal cancer, a medicine not currently routinely available on
the NHS in Scotland.
The report identifies a number of deficiencies in the management of
Mrs Rankin's IPTR.
In light of these findings, the report states that there may be a
need to refresh, clarify or simplify Scottish Government guidance
on the management of IPTRs, including the composition of IPTR
panels and the understanding of clinical need and the criteria for
approving an IPTR.
Scope of the investigation
The scope of the investigation was to examine the concerns raised
on behalf of Mrs Rankin in the context of the adherence to Scottish
Government guidance through NHS Ayrshire & Arran’s local
process for handling IPTRs. The purpose of the investigation was to
assess how NHS Ayrshire & Arran managed the specific aspects of
their local process which had been the subject of complaints by Mr
Graeme Pearson MSP and Mr Willie Coffey MSP. The review was not
asked to consider the decision of the IPTR panel or IPTR appeal
panel, or make any comparison with other IPTR decisions for this
medicine across the NHS in Scotland.
What is an Individual Patient Treatment Request
The Individual Patient Treatment Request (IPTR) process is designed
to provide an opportunity for clinicians to pursue, on a case by
case basis on behalf of individual patients, a medicine that has
not been accepted for routine use by the Scottish Medicines
Consortium (SMC) following their appraisal on clinical and cost
Published Date: 11 June 2013