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Your NHS service rights

You have the right to be fully informed and to share in any decisions about your healthcare.

What guidelines are there for my treatment?

The National Institute for Health and Clinical Excellence (NICE) have recently set out the standard of healthcare that women aged over 18 years with a family history of breast cancer can expect to receive on the NHS in England and Wales.

The NICE recommendations:


  • Are known as 'Clinical guidelines for the classification and care of women at risk of familial breast cancer.'
  • Will provide guidance, presented in different ways, to both medical professionals and the public about what service should be provided.
  • Cover the care of women from their GP's surgery to specialist hospital departments.
  • Include standards for surveillance, referral, genetic testing, risk-reducing interventions and psychological support.
  • Do not include the treatment of men, although it is recognised that the recommendations may be relevant.
  • Do not cover the treatment of women already diagnosed with breast cancer, as procedures are already laid out for this in Breast Cancer Service Guidance, published by NICE in 2002.
  • Only cover England and Wales. Scotland has its own set of recommendations to cover all aspects of breast cancer diagnosis and treatment from the Scottish Intercollegiate Guidelines Network (SIGN).
  • Were published in their final form on the 23rd of June 2004 and updated in October 2006 to include new screening recommendations.

How can I make the most of my treatment?

Members of the Breakthrough Genetics Reference Group have suggested a number of tips for how to make the most of your appointments:

Take a notebook or you'll never remember everything
that they tell you!
  • Take your partner or a friend with you.
  • Take a notebook or you'll never remember everything that they tell you!
  • Make sure you know what to expect before you go. If you are unsure, give them a call and ask - it will make you less nervous when you do go.
  • Make sure that you have all of the information that you need with you - it is frustrating for you if you have to go back again, and probably for the doctor too!
  • Be informed. If you know a bit before you go it will make a lot more sense.
  • Don't make any decisions in a hurry. Everyone will understand if you need to go away and think before making a decision.

What should I do if I am not offered the level of service recommended by NICE?

The guidelines on familial breast cancer issued by NICE (in England and Wales) and the Scottish Intercollegiate Guidelines Network (SIGN, in Scotland) are intended to ensure that everyone gets the same high-quality service. However, there is currently no mechanism in place to make sure that this is the case.

If you feel that you are not receiving the service you are entitled to you can:

Breakthrough can help you with all of these things from finding out who to contact at your local Trust to helping you to draft letters to
send to your MP.
  • Quote the recommendations made by NICE to your hospital and NHS Trust and ask if they will offer you the recommended service.
  • Approach the Patients Advice and Liaison Service (PALS) at your hospital and complain.
  • Write a letter to the NHS Trust manager.
  • Write a letter to your local MP.

Breakthrough can help you with all of these things from finding out who to contact at your local Trust to helping you to draft letters to send to your MP. Please contact us if you have any problems.
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