The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on electrochemotherapy for primary basal cell carcinoma and primary squamous cell carcinoma in February, 2014
This guidance updates and replaces NICE interventional procedure guidance 447 (March 2013).
Changes since first publication
Interventional procedure guidance 447 was reconsidered by the Interventional Procedures Advisory Committee after an internal procedural error was identified. As a result of this changes were made to sections 1.1, 1.3 and 1.5 of the guidance and NICE consulted again on the revised document.
The changes made to the recommendations were:
1.1: References to patient selection and special arrangements for research were removed and a recommendation to submit data to a register added.
1.3: The following text was added: ‘Patient selection is particularly important because the cure rates for established treatments in accessible sites are very high.’
1.5: The following text was added: ‘Entry into research trials should also be considered, with a view to providing data about cure and about recurrence rates, compared with other forms of treatment.’
Some minor changes were also made to the rest of the document after consultation.
Basal cell carcinoma (BCC) is the most common type of skin cancer in the UK. It is generally a slow-growing, locally invasive epidermal skin tumour that rarely spreads to other parts of the body. Although it is not usually life-threatening, the tumour can cause extensive tissue destruction if it is not treated. Squamous cell carcinoma (SCC) is the second most common type of skin cancer in the UK. It may spread into local lymph nodes and metastasise to other parts of the body.
Current treatments for BCC and SCC include surgical excision and radiotherapy, and less commonly curettage, cryotherapy and chemotherapy.
The OPCS-4 codes for Electrochemotherapy for primary basal cell carcinoma and primary squamous cell carcinoma are:
The relevant procurement/delivery codes in categories X70-X72 (depending if this is as an inpatient, outpatient or day case).
Body system chapter code (if applicable)
Y12.3 Electrochemotherapy to lesion of organ NOC
Includes: Electroporation to lesion of organ NOC
Chapter Z site code(s)
Z94.- Laterality of organ (if a paired organ)
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.