[AGENDA ITEM: 8.2]GP(一般医/初期医療)から二次医療への紹介時点で、低優先順位治療法リストにあるものを紹介する場合に、アセスメント手順が必要となる制度の対象リスト拡大するもよう。
ATTACHMENT: H
North Central London Board
14th October 2010
Implementation of the Sector Low Priority Treatment Policy and Plans to Extend its Coverage
セクター低優先順位治療ポリシーの施行と適用範囲の拡張計画
At the meeting of the JCPCT in February 2010 the committee approved in principle the Sector Low Priorities Treatment Policy subject to the development of appropriate plans for its implementation. This paper is intended to update the Sector Board on the progress with implementation and plans to extend the coverage of the Policy.
The Policy and list of treatments covered by the Policy which has undergone some minor changes following the February JCPCT meeting in light of further discussions with PCTS. The list applies across all PCTs with the exception of homeopathy and complementary medicines which does not apply within Camden and Islington currently as this change requires full public consultation which has yet to be undertaken.
2010年2月のJCPCT(joint committee of primary care trusts: 初期医療トラスト合同委員会)の会合で、委員会は、施行のための適切な計画策定に関して、セクター低優先順位治療ポリシーを原則として承認した。本文書は施行の進捗とポリシー適用範囲の拡大についてセクター委員会の情報更新を意図したものである。
ポリシー並びにポリシーの適用範囲に含まれる治療法リストは、初期医療トラストに関する議論に関する2010年2月JCPCT会合にしたがって、マイナーな修正が続けられている。このリストは、CamdenおよびIslingtonでホメオパシーおよび補完医療を適用除外（規定変更に完全な公開協議が必要だが未実施のため））としている以外、すべての初期医療トラストに適用される。
手順そのものは...
i. Management of Referrals in Primary Careこれは、開業しているホメオパスたちではなく、二次医療機関である王立ロンドンホメオパシー病院（王立ロンドン統合医療病院へ名称変更）を直撃するもの。
Where a GP feels that a patient’s condition warrants referral to secondary care and that the treatment options include a procedure contained within the Policy they should refer for assessment only and direct their referral via local referral management centres (RMCs), or in the case of Haringey PCT to a consultant in public health. Referrals will be validated by the RMCs /public health and where appropriate forwarded to the trusts for out-patient appointments to be booked.
ii. Secondary Care
Once patients have been seen in out-patients and any diagnostics required to complete assessment completed, if the consultant’s clinical judgement is that a procedure on the LPT list is required then they should indicate the reason(s) for their recommendation in their clinic letter to the patient’s GP, which should also be copied to the referral management centre/public health consultant. Patients should at this point be discharged to the care of their GP pending the PCTs decision on whether or not to fund treatment.
iii. Approval Process
On receipt of the consultant’s letter the referral management centre/public health consultant will forward the letter, along with the original referral letter and any other relevant information they have received, to colleagues within the PCT for consideration. The PCT will ensure that these are considered and decisions made within 10 working days of receipt (assuming all the information required to make a decision is available). The PCT will notify the patient’s GP and the appropriate consultant of their decision. The patient’s GP will contact them to notify them of the outcome, to advise of the appeal process where appropriate and to discuss alternative treatment options where relevant.
この中央北ロンドンの５つの地区のひとつCamdenの地方紙Camden New Journalによれば...
[Tom Foot: "Threat to Homeopathy patients - North London Sector (NCL) NHS Trust announce plans to extend controversial “low-priority treatments” policy" (2010/10/14) on Camden New Journal]
ホメオパシー患者に対する脅威 -- 北ロンドンセクターNHSトラストは、論争の的である「低優先順位治療法」ポリシーの拡大計画を通達 (2010/10/14)
HOMOEOPATHY patients will have to provide health bosses with “conclusive evidence” that it works before they can be referred for treatment on the NHS.
ホメオパシー患者は、NHSのもとで紹介を受けるために、その治療法が有効であることを決定的に証明する証拠を保健当局に提示することが必要となる。
The North London Sector (NCL) NHS Trust has announced plans to extend its controversial “low-priority treatments” policy to include complementary medicine.
The decision to severely restrict NHS patients’ access to 25 procedures – including wisdom teeth removal, varicose vein surgery, tonsillectomy and male circumcision – was heavily criticised by patient and medical groups when it was first revealed in March.
It means only “special cases” will be treated on the NHS and only after a lengthy appeal process.
北ロンドンセクターNHSトラストは、論争対象の「低優先順位治療法」ポリシーを補完利用を含むようにの拡大する計画を公表した。この決定は、NHSを利用する患者が、親知らずの抜歯や下肢静脈瘤手術や外科扁桃腺摘出術や割礼を含む25の治療法の利用するのを強力に制限するものであり、3月に公表されたとき、患者や医療グループから批判された。これは、長々しい上申手順を踏んだ、特別な症例に対してのみ、NHSのもとで治療を受けられることを意味する。
The proposals to extend the list to include homoeopathy have stoked fears the former Royal London Homoeopathic Hospital in Bloomsbury could be closed.
A spokesman for the Friends of RLHH group said: “The policy is an underhanded process aimed directly at reducing or completely stopping patient referrals to the RLHH.
Under the new system, any patient wanting homoeopathic treatment would have to provide a panel with “conclusive evidence... of the effectiveness of the treatment you are being referred for”.
適用リストをホメオパシーを含むように拡大する提案は、閉鎖の可能性もあるBloomsburyの王立ロンドンホメオパシー病院の不安をかき立てている。王立ロンドンホメオパシー病院後援会のスポークスマンは「このポリシーは王立ロンドンホメオパシー病院への患者紹介の削減あるいは完全な停止を直接目的とした陰謀である。新制度のもとでは、ホメオパシー治療を求める患者は、紹介されたい治療法の有効性を決定的に示す証拠を提示する必要がある。」と述べた。
