A life-extending prostate cancer drug will continue to only be available to sufferers who have already undergone chemotherapy, the NHS financial watchdog said.
In final draft guidance reassessing the use in the NHS in England of abiraterone, the National Institute for Health and Care Excellence (Nice) ruled that to extend the availability of the drug was "not cost effective at its current price."
There is "clear evidence" that the use of abiraterone before chemotherapy gives patients "longer healthier lives," according to The Institute of Cancer Research, where the drug was discovered.
Nice's chief executive Sir Andrew Dillion said: "We know how important it is for patient to have the option to delay chemotherapy and its associated side affects, so we are disappointed not to be able to recommend abiraterone for use in this way.
"However, the manufacturer's own economic model demonstrated that the drug does not offer enough benefit to justify its price."
The chief inspector of GP practices says closing failing surgeries will be a last resort.
Professor Steve Field from the health watchdog Care Quality Commission has spoken to ITV News about a trial to give GP practices a rating.
Those which under perform could be placed in special measures and face closure if they do not raise their standards.
In some surgeries with support the practices can improve and that's fine, but it might be that the doctor in the surgery is a clinician that's acceptable, but is struggling to manage the building and manage the business. It might well be that merging that practice with a local practice might be better or if that doctor worked in a bigger practice. NHS England would then be able to do other things about providing care for the patients, so it's not just about closure. We don't want to close surgeries. We need them, but it's about the care that's provided for the patient.
Professor Steve Field, chief inspector of GP practices for the Care Quality Commission, has told ITV News that a system whereby failing surgeries could be closed is to address 'inconsistencies' across the country.
The health watchdog is trialing an Ofsted-style ratings system for all surgeries. Those that are categorised as 'inadequate' and do not improve within six months will be placed in special measures.
A GP has warned that new Ofsted-style ratings for surgeries could lead to difficulties in recruiting enough doctors into the profession.
Dr Richard Vautrey, who is deputy chair of the British Medical Association's GP Committee, tweeted that a system designed to improve standards could have the opposite effect.
The Care Quality Commission has announced that surgeries which face 'inadequate' ratings under the new system could be threatened with closure.
The Care Quality Commission's planned Ofsted-style rating system for GP surgeries will "confuse patients and won't give them the accurate information that they really need", a leading medic told Good Morning Britain.
Dr Richard Vautrey, deputy chair of the British Medical Association's GP Committee, said "to boil the quality of care down to four simple standards is simply not good enough."
This new regime for GP surgeries could also see more doctors referred to the doctors' regulator, the General Medical Council.
Niall Dickson, chief executive of the GMC, added: "Whenever CQC's new inspection system raises concerns about the competency of individual GPs, the matter will be referred to the GP's local responsible officer and if necessary to the GMC.
"Family doctors are now subject to regular checks, but the inspections in England are bound to expose areas of weakness as well as good practice."
The move follows a similar regime introduced for hospitals which was announced after the Stafford Hospital scandal.
A new regime, which will see GP surgeries given Ofsted-style ratings and potentially forced to close if they don't come up to standard, will "call time on poor care", a regulator inspector said.
Professor Steve Field, the Care Quality Commission's chief inspector of general practice, insisted "most GP practices provide good care" but said that these measures would help to "drive up standards in those that are not providing the services people deserve."
Most GP practices provide good care, we have confirmed this in our pilot inspections so far. But we can't allow those that provide poor care to continue to let their patients have an inadequate service.
I want to do all I can to drive up standards in those that are not providing the services people deserve.
Special measures will firstly promote improvement, but where practices do not improve, working with NHS England we will call time on poor care.
Failing GP surgeries could be forced to close, the health regulator has announced.
England's 8,300 GP practices are to be assessed and given Ofstead-style ratings by inspectors, the Care Quality Commission said.
From October, those deemed "inadequate" will have six months to improve for face being placed in special measures; if they have not improved after six months in the failure regime they could be forced to close.
Exceptionally poorly performing practices will be placed straight into special measures.
Inspectors will be assessing if practices are safe, effective, caring, responsive to people's needs and whether or not they are well led.
A similar regime was introduced for hospitals after the Mid Staffs scandal.
The head of an NHS trust facing special measures after inspectors rated the organisation "inadequate" said they are already "working to address" criticisms.
East Kent Hospitals University NHS Foundation Trust chief executive Stuart Bain said:
Much of what is in the report we have already recognised and we are working to address.
The report does recognise the committed and caring nature of our staff of which we can be very proud. Our task as leaders of the organisation is now to work with our staff and our partners including the Clinical Commissioning Groups to address the issues that have been raised and ensure we provide the residents of east Kent with high quality health care.
Children's services at a hospital managed by an NHS trust facing spacial measures have been deemed "not effective" by inspectors.
The indictment of Queen Elizabeth the Queen Mother Hospital in Margate is among the findings of the Care Quality Commissions inspection into the East Kent Hospitals University NHS Foundation Trust, which has resulted in a recommendation to place the organisation in special measures.
Inspectors also said:
- Surgery at the Kent and Canterbury Hospital was "inadequate."
- A&E waiting times at the William Harvey Hospital in Ashford did "not accurately reflect how long people had waited to be seen."
- The A&E at the Queen Elizabeth the Queen Mother Hospital in Margate was inadequate due to staff shortages.
- There is a "worrying disconnect" between the trust's leaders and front-line staff.
- They found evidence of "ineffective leadership" across a number of clinical services.