Patients in England will be able to top up their treatment with drugs bought privately and yet continue to receive NHS care, provided that they have their top-up treatment administered in a non-NHS setting, the health secretary announced this week.

The change in rules on top-up drugs, which has immediate effect, is part of a package of 14 recommendations made by Mike Richards, England’s national clinical director for cancer, in his review of copayments, all of which the government has accepted.

Taken together the new plans will reduce the number of people seeking private drug treatment from the estimated 5000 patients a year currently to a few hundred people, predicted Professor Richards.

New guidance, which is being sent to all trusts and commissioners in England, says that patients may pay for additional private healthcare while continuing to receive care from the NHS but that there should be no risk of the NHS subsidising their private care. Patients who opt to buy drugs privately will need to pay for any predictable related costs, such as antiemetic drugs, heart scans, and pharmacy and nursing costs, although any unpredictable costs, such as from side effects of drugs, will be covered by the NHS.

The health secretary, Alan Johnson, asked Professor Richards in June to review the rule after …