Hull MP calls for protection to pain therapy in East Yorkshire hospitals

Emma Hardy, the MP for Hull West and Hessle, has asked the Prime Minister, Theresa May, to personally intervene to ensure that patients who currently are given pain infusion therapy will receive it.

Emma expressed concern to the Prime Minister that cuts made to NHS budgets have directly led to the rationing of services that were previously available to patients at the Spire Hospital in East Riding.

The question came about after Emma was contacted by a number of residents in Hull West and Hessle who have been prescribed Intravenous Infusions by their Clinical Pain Management Consultants. This treatment was prescribed because it is the most effective treatment for their chronic pain management. Without this treatment, they would be living in constant pain which effects the whole of their life. Their everyday activities would be seriously curtailed and simple tasks like sitting or sleeping would become intolerable causing them extreme distress.

Although Intravenous Infusion is not normally funded as a matter of course by either Hull or East Riding Clinical Commissioning Groups (CCGs), these patients have been receiving this treatment for several years because it has been accepted that they have exceptional clinical circumstances that justify them getting funding.

As part of the regular review of this funding these patients, through their specialist Pain Management Consultants, have had to provide a supporting management plan to the Individual Funding Request Panel explaining why their exceptional clinical circumstances merits them receiving funding to carry on with the Intravenous Infusion.

Shortly before Christmas, the CCGs informed these patients that the Funding Request Panel has found that there is now a lack of clinical evidence to support the use of this treatment and it will be immediately adjusted and withdrawn over the next twelve months.

Emma is extremely concerned about why so many patients are now having this treatment withdrawn and the repercussions it will inevitably have on their quality of life. She has previously questioned the Secretary of State for Health and Social Care on the issue and has written directly to both Hull and East Riding CCGs as well as NHS England.

Commenting on the cuts to treatment, Emma said: “So far 10 people have come to see me about this same issue. They see their future as a life of severe and constant pain with no light at the end of the tunnel, many have told me they would see no point in continuing to live and the reason why is because they have received letters from either Hull or East Riding CCG informing them that their pain infusion treatment is being cut and then cancelled.

“We all know why this treatment is being removed, it’s nothing to do with NICE guidelines and it’s everything to do with the NHS having to ration treatment because of cuts. The cuts to the NHS shouldn’t be counted in terms of budgets but in lives destroyed. Today I called on the Prime Minister to show some compassion and commit today to both urgently providing Hull and East Riding CCGs with extra funding, and intervening personally in these cases to prevent my constituents facing a life of pain. I won’t stop pushing this government until she’s done both.

In a statement from NHS Hull Clinical Commissioning Group (CCG) and East Riding of Yorkshire CCG - they say they "recently undertook a clinical review of patients who are receiving infusion therapy of either Lidocaine or Phenytoin for the treatment of chronic pain. This treatment is currently being received by 40 Hull patients and 46 East Riding patients and is delivered at the Spire Hospital in Anlaby.

"The National Institute for Health and Care Excellence (NICE) has never recommended infusion therapy for the treatment of chronic pain and there is limited evidence to support the use of recurrent infusion therapy in treating chronic pain. There are also a number of potential side effects.

"For these reasons, infusion therapy for chronic pain has not been routinely commissioned by NHS Hull CCG and East Riding of Yorkshire CCG and this treatment was only approved via an Individual Funding Request (IFR) where a panel reviews requests for this treatment and only approves the treatment in exceptional clinical circumstances.

"Hull CCG held an extraordinary IFR panel on the 19th December 2017 and East Riding CCG on 5 October 2017 to undertake a full clinical review of these patients. In making its decision, each IFR Panel considered the clinical evidence and the plan for managing each patient. In the cases reviewed, both IFR Panels, led by clinicians, did not consider clinical exceptionality in the majority of the cases and therefore did not feel able to continue to approve a treatment indefinitely that has little clinical evidence base to support it.

"Both CCGs are aware that some of these patients have been receiving infusion therapy treatment for some time and are making arrangements for a clinical review to be undertaken by specialist pain management services with each patient and to put a plan in place that will best meet each patient’s longer-term pain management needs. Until these reviews are undertaken the majority of patients will receive one infusion every 12 weeks, until the end of January 2019 or until alternative treatment plans are agreed"