Rarer Cancers Forum carried out an audit of the policies and processes used by PCTs to determine exceptional funding requests.  The audit found that:

• 5,000 patients have been forced to demonstrate their ‘exceptionality’ in the past 20 months, in order to receive cancer treatments not recommended by the National Institute for Health and Clinical Excellence (NICE). 1,300 had their requests rejected.
• Huge variations between PCTs’ processes in deciding on ‘exceptional cases’, with some areas approving all requests, and some approving none at all.
• A worrying lack of understanding amongst PCTs of the rules surrounding exceptional cases, and of the Department of Health’s policy to improve transparency in decision-making.

The report, Taking Exception, makes a number of recommendations including the following:

• National guidance should be published informing PCTs how they should process exceptional cases, so that there is greater consistency across the country.
• A target should be set for PCTs to process exceptional case applications quickly.
• NICE’s appraisal process should be improved to minimise the number of patients needing to make an exceptional funding request.
  

The findings were exposed by Freedom of Information requests sent by the Rarer Cancers Forum to every Primary Care Trust in England. The report of the key findings is to be submitted to the Department of Health.