On 1 April 2013, NHS England took on responsibility for the operational management of the Cancer Drugs Fund (CDF).
The CDF provides an additional £200m each year to enable patients to access drugs that are not routinely funded by the NHS. It was established in 2010 and will run until the end of March 2014.
There is now a single, national list of drugs and indications that the CDF will routinely fund and standard operating procedures for administration of the fund.
The list of drugs and indications has been compiled by NHS England Clinical Reference Group (CRG) for Chemotherapy working with the local clinician leads who oversaw the administration of the ten regional CDFs.
The CRG for Chemotherapy will continue to play a key role in the management of the CDF. The chair will make recommendations to NHS England as to how the list should be developed and the group will adopt a formal process of horizon-scanning for new treatments which could have potential benefits for specific groups (cohorts) of patients.
NHS England will oversee the fund, with day to day administration carried out by the four regional area teams based in the following areas:
- North of England
NHS England Area Team: Cumbria, Northumberland, Tyne & Wear
- Midlands and East
NHS England Area Team: Leicestershire and Lincolnshire
- South of England
NHS England Area Team: Wessex
NHS England Area Team: London
The list of drugs and associated indications that will be routinely funded by the CDF is available here. Additionally, NHS England will consider Individual CDF Requests (ICDFRs) for cancer medicines to treat individuals with rarer types of cancers including those affecting children. This list was last updated on 18 June 2013.
The CDF Standard Operating Procedures document sets out how the fund will be managed and the process for applications – both for drugs with an identified cohort of patients and for Individual CDF Requests. It includes further guidance for clinicians and information specifically for patients.
Applications to the fund must be made on behalf of patients by a recognised and accredited cancer specialist and must be supported by the NHS trust/foundation trust’s clinical cancer lead. Each drug and indication has its own application form and all relevant clinical criteria for use have to be satisfied.
Detailed information on eligibility, the evidence required and the procedure for applications can be found in the CDF Standard Operating Procedures. In summary, the process will follow the steps below.
- Applications for inclusion into the national list of cohort policies will be assessed primarily on the strength and quality of the evidence of clinical effectiveness and anticipated delivery of measurable outcomes such as improved survival rate and quality of life. This process will be conducted by the Chemotherapy CRG.
- Applications for individual patients will be processed by the four area teams and should be submitted according to the geographical location of the provider of treatment. Access to the application process is through the links set out at the foot of the page.
- If there is an agreed cohort policy for a drug to be funded by the CDF, applications should be submitted online and, where the relevant criteria are met, funding will be confirmed.
- ICDFRs for drugs outside the cohort policies will be assessed by the clinically led CDF panels which will be located within each of the four regions. These four panels will use a single, consistent assessment process harnessing a variety of technologies to share and discuss cases to ensure consistent outcomes for patients across England.
- The four regional panels will inform the national CRG for Chemotherapy, which will take decisions about new cohort policies when a group of patients requiring the same funding is identified.
- A request for review of a CDF decision may be made by the referring clinician to the NHS England Regional Medical Director. However, this can only be requested on the basis that the applying clinician believes the CDF panel failed to follow due process or did not take full account of all relevant evidence. The appeals process will not revisit the merit of the original application, only the process under which it was considered.
The Individual Cancer Drug Fund Request form can be found here. Application forms and details of how to submit requests to the CDF are also available: