Information about whether you can demand a specific treatment, including getting a second opinion and what role the National Institute for Health and Care Excellence (NICE) plays in recommending NHS treatments.
Your GP doesn't have to prescribe a particular medication or treatment for you if they think it's not the right option. You're entitled to ask for their reasons for the decision.
You're also entitled to make a suggestion and explain to your GP why you believe a certain medication or treatment is a good option.
- some types of treatment aren't available on the NHS
- you need a referral from your GP to have some types of treatment on the NHS, such as cosmetic surgery
If you're not satisfied with your GP's advice, you may want to consider getting a second opinion.
Although you're not legally entitled to a second opinion, a healthcare professional will rarely refuse to refer you.
You may feel happier with a different GP, but be aware they may give you the same advice.
NICE and NHS medicines and treatments
The National Institute for Health and Care Excellence (NICE) regularly looks at new medication and treatments to assess whether they:
- are safe
- are more or less effective than other medication or treatments
- represent value for money by assessing how well a medication or treatment works in relation to its cost
NICE won't automatically reject a medication or treatment because it's expensive. NICE recognises that something can be both expensive and represent good value for money.
The NHS in England and Wales is legally obliged to fund medicines and treatments NICE recommends.
This means that when NICE recommends a medicine or treatment, the NHS must ensure it's available to those people it could help, normally within 3 months of the guidance being issued.
So, if your doctor thinks a medicine or treatment recommended by NICE is right for you, you should be able to get it on the NHS.
Medicines and treatments not recommended or assessed by NICE
The NHS isn't legally obliged to fund a medicine or treatment not recommended by NICE, even if your GP thinks it would benefit you.
In fact, most NHS medicines and treatments have never been looked at by NICE. The Department of Health (DH) only asks NICE to provide guidance when there's uncertainty over the use of a treatment.
All medicines must be licensed by the Medicines and Healthcare products Regulatory Agency (MHRA). There's no ban on prescribing licensed medicines NICE hasn't yet assessed or where a NICE appraisal is in progress.
The DH has issued clear guidance to local organisations, such as clinical commissioning groups (CCGs) and NHS trusts, on what to do when NICE hasn't issued guidance on a new medicine.
In these circumstances, the DH expects CCGs to take into account all the evidence available when deciding whether to fund treatments.