Treatments and interventions for islanders’ future healthcare will be “prioritised” as part of a programme to combat rising costs, the government has confirmed.
The Health Department is to set up a new system where a panel of clinical experts will make “difficult choices based on evidence, clinical effectiveness and value for money” about whether certain treatments will be publicly-funded.
In setting up the new prioritisation policy, Jersey will move away – in some cases – from UK guidelines established by the National Institute for Health and Care Excellence (NICE).
What will or won’t Jersey fund?
Health Minister Tom Binet and officials from his department are seeking to tackle rapidly-rising health costs, with the prioritisation policy sitting alongside other initiatives announced in the Budget such as penalties for patients who fail to attend hospital appointments and charges for inappropriate use of the Emergency Department.
The removal of varicose veins for cosmetic reasons and taking out tonsils are examples of areas where treatment may no longer be free, according to Deputy Medical Director Dr John McInerney.
He said: “No-one who’s got a treatment planned or is on a waiting list will see any change, but going forwards we’ve got a policy that will make it more transparent to both patients and GPs what treatments are funded.
“It gives the GP and patients a bit more understanding what our health system will fund, and it makes it much more easier for everyone to plan.”
Not so NICE…
Experts sitting on the Health Advisory Board have repeatedly stressed the importance of Jersey following NICE guidelines, however the new framework will mean the island follows Scotland, Wales, Northern Ireland and the other Crown Dependencies in taking a more bespoke approach.
Public Health Director Professor Peter Bradley said: “NICE guidelines are still going to be very, very important, and they offer us a really good guidance on what future care should be, but there is a need for us to see that in the light of the Jersey health system.
“Sometimes we may find that we offer treatments that are not advised by NICE, so it could work either way, but what’s really important is that we’re offering patients the care that they need and the care that can best be offered on the island.”
Scotland, Wales and Northern Ireland do not routinely follow NICE guidelines, but set their own policies on which medicines and treatments are available for free in their NHS hospitals.
In moving out of sync with NICE, Deputy Binet said Jersey was recognising the reality that the island could not compete with the economy of scale existing in the UK, the world’s sixth-largest economy.
Professor Bradley and Dr McInerney will be part of the decision-making panel, alongside the Chief Pharmacist, the Health Department’s Finance Director, and a GP representative.
Recommendations from the panel will go to the advisory board with the ultimate say lying with Deputy Binet and his ministerial team, while an appeals procedure will enable islanders or GPs to challenge decisions that have been made.
Big budget boost
Deputy Binet said he anticipated the entire evaluation process would take five years, tying in with the anticipated opening of the island’s new Hospital at Overdale.
During a briefing on healthcare funding, it was pointed out the international forecasts showed that health spending would grow twice as fast as government revenue over the next 15 years, while the NHS in the UK had a forecast deficit of £6.6 billion for 2025.
Specific Jersey issues include a rise in the cost of referring patients to the UK from 11.7m to £18.7m between 2015 and 2024, and a 70% rise in the cost of adult mental health placements in the UK.
According to Ministers’ recently published spending plans for 2026 and beyond, Health is due to get the largest amount of funding of any department, standing at £381m.
More than £60m – £15.6m a year until 2029 – is also earmarked to plug the department’s long-running deficit.
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