Section 7 of the National Institute for Health and Care Excellence (Constitution and Functions) and the Health and Social Care Information Centre (Functions) Regulations 2013 requires integrated care boards, NHS England and, with respect to their public health functions, local authorities to comply with the recommendations in this evaluation within 3 months of its date of publication.
The Welsh ministers have issued directions to the NHS in Wales on implementing NICE technology appraisal guidance. When a NICE technology appraisal guidance recommends the use of a drug or treatment, or other technology, the NHS in Wales must usually provide funding and resources for it within 2 months of the first publication of the final draft guidance.
When NICE recommends a treatment 'as an option', the NHS must make sure it is available within the period set out in the paragraphs above. This means that, if a patient has hormone-refractory metastatic prostate cancer with a Karnofsky performance-status score of 60% or more, and the healthcare professional responsible for their care thinks that docetaxel is the right treatment, it should be available for use, in line with NICE's recommendations.
NHS organisations and clinicians who care for men with prostate cancer should review their current practice and policies to take account of the guidance set out in section 1.
Local guidelines, protocols or care pathways that refer to the care of men with prostate cancer should incorporate the guidance.
To measure compliance locally with the guidance, the following criteria could be used. Further details on suggestions for audit are presented in appendix A.
A man with hormone-refractory metastatic prostate cancer is offered docetaxel, within its licensed indications, as a treatment option only if his Karnofsky performance-status score is 60% or more.
For a man with hormone-refractory metastatic prostate cancer who is treated with docetaxel, treatment with docetaxel is stopped when any of the following circumstances occur:
planned treatment of up to 10 cycles is completed or
the man experiences a severe adverse event or
there is evidence of progression of disease.
Repeat cycles of treatment with docetaxel are not provided if the disease recurs after completion of the planned course of chemotherapy.