4 NHS considerations

System impact

4.1 The evidence suggests that the PleurX peritoneal catheter drainage system is a safe and effective alternative to inpatient large-volume paracentesis, is cost saving and reduces hospital bed use.

Committee considerations

4.2 The clinical experts advised the committee that the PleurX peritoneal catheter insertion procedure is unlikely to be more costly to the NHS than the large-volume paracentesis procedure.

4.3 The main resource consideration with PleurX is the relative need for community nursing support for the ongoing drainage procedures. However, the committee was advised that the PleurX peritoneal catheter drainage system is unlikely to increase overall community nursing input as was assumed in the cost model (see section 5). This is because most patients in the terminal stages of cancer need community nursing support regardless of the PleurX peritoneal catheter drainage system, and large-volume-paracentesis is associated with a greater need for nursing for overall wound management. Indeed, the committee was advised that it is possible that using the PleurX peritoneal catheter drainage system could lead to an overall reduction in community nursing costs, which would further enhance the resource savings associated with its use.

4.4 The committee recognised that training is needed for community nurses, patients or carers to perform drainage procedures in a community setting.

  • National Institute for Health and Care Excellence (NICE)