Newspapers tell us heart-rending stories of people refused potentially life-saving treatment because it is too expensive...

"Betrayed by the NHS: Doctor who gave her life to health service is refused vital cancer drugs that could save her.."  A UK primary care trust "has refused to fund [this treatment] because it has not been fully approved by the rationing body, the National Institute for Clinical Excellence (NICE)."  Mail Online, 1 March 2011

Yet we all know difficult decisions have to be made: there is not enough health-care to go round, and the pressures on Health Service budgets are growing. Even if healthcare budgets were increased, by taking money from other services, there would still not be enough to pay for everything that is demanded.

Dr Sarah Garner, who features in the video clips in this pack, is one of the people whose work helps NICE decide whether to approve a new treatment for use in the NHS. The video clips will help students to understand why decisions like this need to be made, and how they are made.  


The resources in this pack complement the video clips, providing activities designed to help students understand some of the financial and other constraints which affect what treatment can be offered to people on the NHS.  Some are designed to be used with the video clips, while others extend and/or provide alternative approaches to the topic.  Answers and additional notes are also provided.

Suggested route:

Any resource can be used on its own, although we would strongly recommend that students watch the preceding video(s) so that they understand the context of the resources.

Type of Resource Resource Name Notes
notes icon Answers and notes

Teachers: Start here!
Additional notes on answers and areas for further discussion

video icon How do we decide? Introductory video clip (1 min 41 secs)
video icon Comparing Treatments Video clip (1 min 22 secs)
presentation icon Comparing Treatments Follow-up presentation 
worksheet icon Maximising Survival  Worksheet - using calculation, a graph and an equation to decide on a strategy.  This is quite a long worksheet in two parts, so you could use just the first part, or set the second part as a follow-up exercise or homework.
video icon But is it cost-effective? Video clip (1 min 22 secs)
worksheet icon But is it cost-effective? Follow-up worksheet - calculations, manipulation of an equation, percentage increase.
video icon Treatment X versus Treatment Y Video clip (1 min 41 secs)
worksheet icon Which Treatment? Follow-up worksheet - calculations, graph used as a decision-making tool
video icon Ethical Issues Video clip (2 mins 15 secs)
worksheet icon Making Decisions Worksheet - probability, tree diagrams
presentation iconactivity icon The Survival Game Presentation and exemplar game - these are alternative and complementary ways of presenting the same sample game designed to illustrate the kinds of decisions that need to be made and how they are recorded on the grid
worksheet iconactivity icon The Survival Game Game - rules and playing grid - a game to be played in groups of 3-5 players, in which players have to make decisions which will decide how many people survive an outbreak of a new illness.  Each group will need a set of rules between them and a playing grid each.