7 Implementation


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NHS in Wales must usually provide funding and resources for it within 2 months of the first publication of the final draft guidance.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 advanced breast cancer and the doctor responsible for their care thinks that trastuzumab is the right treatment, it should be available for use, in line with NICE's recommendations.


Clinicians with responsibility for treating women with breast cancer should review their current practice in the light of the guidance set out in section 1.


Local clinical guidelines and protocols for the management of women with breast cancer should be reviewed in the light of this guidance.


It is likely that the rate of HER2 testing will increase as a result of this guidance. The suitability of current service provision for HER2 testing should be reviewed in the light of the guidance set out in section 1.3.


Prospective clinical audit programmes should record the proportion of treatments adhering to this guidance. Such programmes are likely to be more effective in improving patient care when they form part of the organisation's formal clinical governance arrangements and where they are linked to specific post-graduate activities.