Open Door - November 2010 page 3
- Licence updates
- NICE to review MS guideline
- Equality Act comes into force
- Report criticises continence care
In September 2010, the European Medicines Agency (EMA) rejected the licence application for cladribine, a potential oral treatment for MS. The regulators decided that the benefits of the drug did not outweigh the risks, and were concerned about four cases of cancer observed during clinical testing and about the drug's effect on the immune system. The news came days after the American Food and Drug Administration (FDA) approved fingolimod (Gilenya), another disease modifying drug taken as a tablet, as a treatment for relapsing forms of MS. Fingolimod is still being appraised by the EMA with a decision not expected before 2011.
NICE to review MS guideline
NICE (the National Institute for Health and Clinical Excellence) has confirmed that their guideline Management of multiple sclerosis in primary and secondary care is scheduled for review in November 2010. If it is decided that a full update is necessary, this could take over a year to complete.
The Guideline was originally launched in 2003 and brought together existing evidence and good practice to define a reasonable level of care for everyone with MS across England. Since publication, significant changes have occurred in the management of MS, including the licensing of new treatments such as Sativex for spasticity and functional electrical stimulation (FES) for dropped foot; the updating of diagnostic criteria for MS; and the publication of a consensus statement on the management of the bladder in MS.
The disease modifying drugs for MS are covered by other NICE appraisals and are not part of the Guideline.
The MS Trust has worked with the Royal College of Physicians on a series of audits to monitor implementation of the Guideline within the NHS (see article in this issue).
Equality Act comes into force
The majority of the provisions of the new Equality Act came into force on 1 October. The new Act brings together nine separate pieces of antidiscrimination legislation, including the Disability Discrimination Act, and extends protection in a number of ways including:
- Protecting people from discrimination because they associate with someone who has a disability, such as family members or carers
- Protection from indirect discrimination, such as an employer making general changes that have a disproportionate effect on employees with a disability
Report criticises continence care
A national audit of continence care reports that services are failing people.
The report, published by the Royal College of Physicians, is particularly critical of services for older people and those living in care homes.
Key findings include:
- Diagnosis and treatment of incontinence is often poor or non-existent
- Continence services are poorly integrated across NHS services resulting in disjointed care for patients and carers
- Often there is no single person responsible for commissioning and improving continence services
- Training of healthcare professionals is inadequate
- Patients are rarely consulted for advice in commissioning services
- Services often fail to meet the standards set out by NICE guidelines