I am writing as chief executive of Oxfordshire PCT to express my disappointment at the tone and content of your editorial on February 4, concerning the funding of Sunitinib for renal cancer patients.

We welcome the draft guidance from NICE, which was published last week, as it now provides clear direction to local NHS organisations.

But also because we are only too aware of the strength of feeling about this drug and, indeed, have come to know the individuals concerned and their families.

You suggest that that the PCT has “dithered” over this issue.

We refute this strongly.

The PCT established a policy, using the current national criterion on cost effectiveness which was later endorsed by NICE and implemented by over 100 other PCTs in England.

In January 2009, NICE changed its criteria on cost effectiveness (to give greater weight to life extending drugs), which is the reason why it is now able to approve Sunitinib.

Further, the drug company which makes Sunitinib has now offered to pay for the first six weeks of treatment, which also helps make it more affordable to the NHS.

The PCT has applied its current policy consistently through a panel where the majority of members are local cancer specialists.

We have not given detailed explanations to the media about why a small number of patients receive funding approval as this would result in an unacceptable breach of patient confidentiality.

However, our policy on ‘exceptionality’ is available on our website (oxfordshirepct.nhs.uk).

The PCT will now change its policy following the publication of the final NICE recommendations and has already been working with our local clinicians about making the drug available locally.

At our November Board meeting we publicly committed to implement any change in policy from NICE on Sunitinib, as quickly as possible.

I also have to correct your statement that all manner of cosmetic surgery is available on the NHS. For over a decade Oxfordshire PCT and its predecessors have had policies which strictly limit such surgery.

We are absolutely committed to making every pound count in Oxfordshire, and ensure the money we spend, on behalf of the taxpayer, is appropriate and backed by evidence of effectiveness.

We do not shy away from the difficult decisions this presents, but do involve lay members, clinicians and expert advisors in making those decisions.

Andrea Young

Chief Executive

Oxfordshire PCT