Why the NHS decision to cease funding second bone marrow transplants is a matter of life and death

[Image credit: Antony Nolan Trust]

On July 21st, an open letter was presented to Jeremy Hunt, the Health Secretary by Anthony Nolan. It was calling for the government to step in and intervene on a decision announced earlier this month.

Earlier this month, while the country was still reeling after the Brexit vote, the government announced that it is going to stop funding second bone marrow transplants (BMT) on the NHS for individuals with blood disorders, cancer or any other conditions that are treated by BMT. Children and adults with relapsed leukaemia form the majority of the cases.

This decision will involve the 20 or so adults and children a year in the UK that need this treatment as their only chance of survival.

The open letter has gained the backing of over 30 experts in the transplant community, and in just six days, has gained a staggering 18,000 signatures nationally, with the number rapidly rising.

In the letter to Jeremy Hunt, over 30 experts representing the transplant community said: "Without a second stem cell transplant, many of these patients will die. With another transplant, there is hope; evidence suggests there is a one in three chance that they will achieve the milestone of five year survival. There are many people alive today, leading fulfilling and active lives with their families, after a second transplant."

This is such an emotive subject because a bone marrow transplant can be curative in these individuals. In essence, children and adults who relapse after their initial treatment of a bone marrow transplant will be left with no options - without BMT, they devastatingly will not survive.

In their response to NHS England, Anthony Nolan wrote: "We believe this is simply wrong. If a stem cell transplant is the best option for a patient, and a donor can be found, we believe the treatment should be available."

The announcement for the loss of funding for second BMT was released as a part of the NHS England announcement about investment for specialised services.

In the same report, there was the decision made that funding would be given to penile prostheses for erectile dysfunction and obesity surgery for children amongst other decisions. It was stated that on paper, these areas were found to be more cost-effective. 

Decision-making on funding and commissioning is notoriously hard, and not everyone can be pleased. However, given the scale of the reaction to this decision and the lives that will be lost, we would hope that NHS England may revisit this decision.

Anthony Nolan and a number of specialists leading their field in BMT are campaigning to fight this. Please visit the charity's website for more details on how to help.

References:

Grace Kelly Ladybird Trust

Anthony Nolan

NHS England - https://www.england.nhs.uk/2016/07/spec-services-investment


Dr Jennifer Kelly is a GP and founder of the Grace Kelly Ladybird Trust (for awareness and research into childhood cancers).