Template letter A
- To submit a formal complaint about lack of access to NICE-approved
To copy and paste this letter or to download this letter as a word document,
Insert your name
Name of Chief Executive of PCT
Address and postcode
Dear, [insert name of Chief Executive]
Formal complaint: Access to [insert name of drug]
As a patient with MS and/or as a member of the local MS Society branch, I am
extremely concerned that [insert name of drug], which is approved by the National
Institute for Health and Clinical Excellence (NICE) as a treatment for multiple
sclerosis, is not being prescribed by [insert name of Trust]. I would therefore like to
register this letter as a formal complaint.
[insert name of drug] is licensed for use in the UK and was approved by NICE in
[insert date] for patients with [insert type of MS] MS. As you will be aware,
technology appraisals (TAs) from NICE carry a three month implementation period;
after this period the Primary Care Trust has a legal obligation to fund the approved
treatment. The directions enforcing this provision derive from Section 97 of the NHS
Act 1977 as amended by the Health Act of 1999.
The Secretary of State has directed that the NHS provides funding and resources for
medicines and treatments recommended by NICE technology appraisals. This is
reinforced by the NICE Compliance Regime which requires NICE technology
appraisals to be automatically incorporated into local NHS formularies. This is
supported by the NHS Constitution which states that patients have the right to
access NICE approved drugs on the NHS where a doctor believes it to be clinically
appropriate. I would urge the Trust to review tools developed by NICE to help
organisations implement its guidance on [insert name of drug].
If you have been told you are eligible for the treatment (or know of others
who are eligible) and have been refused, state the reasons you have been
told/have heard for the refusal e.g. lack of space within the Trust to set up an
infusion unit, lack of capacity in terms of nursing staff to run an infusion unit
or lack of resources.
Use this as an opportunity to state clearly, in a few sentences, your concerns
e.g. a lengthy delay could mean that you no longer fulfil the clinical criteria
set out by NICE.
If you are a branch member and know of others in your area who are being
denied treatment; state this here.
I would appreciate a response detailing why the treatment has not been made
available to patients with MS in [insert location] area. In the response, I would like
the Trust to outline what actions it will take, how and when to resolve this situation
as soon as possible. I hope this issue will be addressed as a matter of urgency.
[Insert signature and full name]
The MS Society recommends that you consider copying your letter to the following
key influential people who can help to resolve your case:
CC. Name and address of consultant neurologist
CC. Name and address of your local MP
CC. Name and address of your PALS manager
To make absolutely sure that your letter is logged as an official complaint, copy and
paste your letter into an official PALS complaints form to ensure your letter is
registered under the NHS formal complaints procedure. The form should be available
on each PALS website – to find your local PALS, enter your postcode here:
Don’t forget to send a copy of your letter to the policy and campaigns team by
emailing: firstname.lastname@example.org or send a hard copy of your letter to: MS
Drugs Campaign, Policy and Campaigns, MS National Centre, 372 Edgware Road,
Cricklewood, London, NW2 6ND.