To ask the Secretary of State for Health what guidance has been issued on the use by NHS trusts of treatments within a class of treatments during the period of the appraisal of that class of treatments by the National Institute for Clinical Excellence; and what steps are taken to ensure that guidance is followed.

Health Service Circular 1999/176, issued in August 1999, indicates that national health service bodies should continue with local arrangements for the managed introduction of new technologies where guidance from the National Institute for Clinical Excellence (NICE) is not available at the time the technology first becomes available. These arrangements should involve an assessment of the available evidence on clinical effectiveness.

Following the Department's Shifting the Balance of Power" initiative, responsibility for local health services lies with the local NHS. It is now for primary care trusts, in partnership with strategic health authorities and other local stakeholders, to plan, develop and improve services for local people in accordance with national standards that include following NICE guidance.