7 Implementation and audit

7 Implementation and audit

7.1 When NICE recommends a treatment 'as an option', the NHS must make sure it is available within 3 months of this guidance being published. This means that, if a patient has chronic myeloid leukaemia and the doctor responsible for their care thinks that imatinib is the right treatment, it should be available for use, in line with NICE's recommendations.

7.2 All clinicians who treat people with CML should review their current policies and practice in line with the guidance set out in Section 1.

7.3 Local guidelines or care pathways for the care of patients with CML should incorporate the guidance.

7.4 To measure compliance locally with the guidance, the following criteria could be used. Further details on suggestions for audit are presented in Appendix C.

7.4.1 Imatinib is provided as first-line treatment for the management of an individual with Philadelphia-chromosome-positive CML in the chronic phase.

7.4.2 Imatinib is considered as an option for the treatment of an individual with Philadelphia-chromosome-positive CML who initially presents in the accelerated phase or in blast crisis or who presents in the chronic phase and then progresses to the accelerated phase or blast crisis if he or she has not received imatinib previously.

7.4.3 For an individual in chronic-phase CML who is currently receiving IFN-α as first-line treatment, the decision to change to imatinib is informed by the response of the disease to current treatment and the individual's tolerance of IFN-α, after informed discussion between the individual and the clinician responsible for treatment.