Letters: Dr Peter Tasker, July 26, 2016

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Shortly after retiring as a King’s Lynn GP of 33 years I was diagnosed with acute leukaemia which required intensive chemotherapy in our local hospital and a subsequent stem cell transplant in Addenbrooke’s Hospital in 2013, all of which was funded by the NHS.

Fortunately, so far, the treatment has been successful and I am now able to enjoy a relatively normal and full retirement. When I was an inpatient for a month or so in Cambridge I witnessed and got to know patients having second stem cell transplants, some of whom now enjoy good health. This week NHS England rejected a proposal to fund second stem cell transplants for blood cancer in adults and children who have relapsed. This was despite the fact that the treatment was available to patients before 2013. Blood cancers include leukaemia, lymphomas and myeloma, all of which may be treated with stem cell transplants.

I consider it a gross misjudgement of NHS England to decline funding for this treatment. It is a denial of basic human rights – hopefully a situation I will not have to face myself.

Leading doctors have joined blood cancer charity Anthony Nolan in criticising the NHS for a money-saving policy that ‘will cost lives’.

Anthony Nolan and more than 20 top clinicians have urged the government to intervene before lives are lost. The public is also asked to voice their concerns by signing an open letter to the Health Secretary. Announcing the decision, NHS England said this was among proposals that ‘are not currently affordable… these policies will be considered again next year in the relative prioritisation process for 2017/18’.

The decision means anyone with blood cancer or a blood disorder who has had one donor transplant already and subsequently relapsed will be denied the treatment that could offer them their best chance of survival.

The judgement comes despite a group of experts, including clinicians and patients, recommending second transplants are funded and a public consultation – a process which included Anthony Nolan. However, their recommendation was not accepted by NHS England.

In a letter, the experts representing the transplant community said: “With this decision, NHS England is ignoring the advice of the clinical community, thereby effectively handing most of these patients a death sentence. Without a second stem cell transplant, many of these patients will die. With another transplant, there is hope; evidence suggests there is a one-in-three chance that they will achieve the milestone of five year survival. There are many people alive today, leading fulfilling and active lives with their families, after a second transplant.”

Before 2013, patients in need of a second transplant received the potentially lifesaving treatment they needed. In the same circumstances today, these people would be denied the treatment that saved their life.

A recent study found that of patients who receive a second transplant, one-in-three achieved the five-year survival milestone. Henny Braund, chief executive at Anthony Nolan, said: “If a patient is willing to undergo the procedure, if their consultant believes a transplant is their best option, and if a donor is willing to provide their stem cells, it is devastating that NHS England will deny them a second chance of life. Patients are left with only one option which is unlikely to succeed and very stressful to experience. If second transplants are not ‘routinely commissioned’, every patient in need will be required to make their own Individual Funding Request. The bar is set very high and the odds are stacked against the patient unless they can show they are an exceptional case; this will be even harder with the precedent set by the recent NHS England decision.”

Anthony Nolan has published an open letter to the Secretary of State for Health urging that the NHS funding decision be reconsidered.

To add your name to the letter, visit: https://www.anthonynolan.org/news/2016/07/14/our-letter-following-nhs-england-announcement-funding-second-transplants

Dr Peter R W Tasker, via email