ANN was beginning to hope she was in the clear when her doctor told her the test results.

The 55 year old from Newton Aycliffe had responded well to treatment for breast cancer. But in November 2001 - four years after she thought she had beaten cancer - her doctor broke the news that she had chronic myeloid leukaemia.

Ann, who is married and has a teenage son, was determined to fight CML, a dangerous form of blood cancer which affects about 4,000 Britons at any one time. Specialists at Newcastle's Royal Victoria Infirmary put Ann on a course of interferon chemotherapy, unpleasant treatment which can lead to side-effects including hair loss.

Some patients respond well but, in Ann's case, regular infusions of interferon didn't work. Early this year, during her interferon treatment, she asked about the availability of Glivec, a completely new type of drug, pioneered in the North-East, which has a fantastic early track record with leukaemia patients.

Reports from America show that Glivec can eradicate CML in 69 per cent of cases compared to the 11 per cent success rate of standard chemotherapy. In effect, Glivec seems to completely "cure" the disease.

Unlike conventional treatments, Glivec only targets cancer cells, has virtually no side-effects and is taken as a daily pill.

One specialist described the Glivec results as "simply stunning."

While Glivec is licensed for use in the UK, it is currently being vetted by the National Institute for Clinical Excellence (NICE), the quango set up by the Government to approve or reject potential new NHS drugs.

The practical effect of a NICE vetting appears to be the virtual freezing of drug supplies to new patients - something which Ann Tittley was soon to discover when she broached the subject with her consultant at Newcastle.

"I knew another patient who was already on Glivec who was doing well and I also got lots of information about Glivec from the Internet," says Ann.

At that stage, her Newcastle consultant explained that Glivec was a very new drug which could only be prescribed to patients who had failed to respond to conventional chemotherapy.

"I can remember her saying that if you fail the first treatment you can have Glivec. She was most adamant about that."

But when interferon didn't work, instead of being put on the new wonder-drug, Ann was told that that Glivec was no longer available.

"It seemed that because of the referral to NICE a hold had been put on supplies of the drug. I was so angry," she says.

After months of deadlock - acutely aware that the clock was ticking - Ann took the bull by the horns and wrote to her MP - Prime Minister Tony Blair and decided to go public.

She was particularly incensed at reports that Glivec had been approved by the Scottish equivalent of NICE but was not available south of the border.

Ann asked the Sedgefield MP whether she and her family needed to move to Scotland to get treatment - and sent a copy of the letter to The Northern Echo.

Before she knew it, she found herself appearing in the national press and on television.

Mr Blair's agent wrote back explaining that it was up to "individual health organisations" to consider the evidence on treatment when deciding whether to fund new drugs being considered by NICE. The agent, John Burton, agreed that preliminary clinical trials involving Glivec were "very promising."

Ann Tittley's experience has highlighted continuing concerns from patient groups, doctors and the pharmaceutical industry at the length of time taken by NICE to assess and approve new drugs - and apparent confusion within the NHS whether new drugs can continue to be prescribed during a NICE appraisal.

While the Government set up NICE three years ago to try to resolve the problems of so-called postcode rationing, the very existence of NICE has led to a phenomenon, commonly known as "NICE-blight" when prescriptions to new patients are put on hold throughout the NHS pending an investigation.

While NICE officials say they never intended this to happen, many patients are denied access to potentially life-saving drugs for a year or even longer.

In some cases that delay could affect the life-expectancy of patients.

With supplies of Glivec for new patients on hold at the region's leading haematological centre on Tyneside, Ann turned to her local specialist at Bishop Auckland General Hospital, Dr Mohsen Mahmood.

His reaction was to write to John Saxby, chief executive of the South Durham Health Care NHS Trust and Nigel Porter, chief executive of the Sedgefield Primary Care Trust, backing Mrs Tittley's request for Glivec.

"In my letter I was telling them it was an unacceptable situation. I have a young and healthy patient who survived breast cancer, who now needs another drug," said Dr Mahmood.

"I am the one who is facing the patient. I have a responsibility to them. I can't just accept the situation when time is going on," he says.

Mrs Tittley rang Mr Porter at his office in Sedgefield and tackled him head-on about Glivec.

She was pleasantly surprised when he said he would do all he could to help her. And within a few weeks of that phone conversation, Dr Mahmood was explaining to an emergency meeting of Bishop Auckland hospital's drug and therapeutic committee why his patient should be prescribed Glivec.

"It was crystal clear that the patient needs the drug. It was all over in 20 minutes," he adds.

That meeting was held a week ago and, yesterday, Mrs Tittley was due to begin a course of Glivec pills. Mrs Tittley, who works with disabled people at a Newton Aycliffe centre, says she is "delighted and very, very relieved" at the news but is angry that she has had to make such a fuss.

"I can't understand that I have had to go through all this to get the drug I need. I just hope it will help other people to get Glivec," she says.

The hospital and the primary care trust - which now holds the drug budget for the Sedgefield area - both deny that the issue is about funding, although the British Society of Haematologists suspect that fears about escalating drug costs is the root cause of delays.

Dr Mahmood believes the main problem is caused by a widespread misunderstanding of the NICE process.

"There is some confusion about the NICE guidance on Glivec. The truth is that NICE has not produced any guidance on this drug. It has only produced a consultation document," he adds.

Instead of reading the small print, hospitals and primary care trusts have simply put access to the drug on hold, he complains.

According to Dr Mahmood, all any doctor needs to do to obtain Glivec - or any other drug being considered by NICE - is to make the case on the basis of the patient's suitability and the track record of the drug.

But rather than having to argue the case for every patient, Dr Mahmood says that, where new drugs can save lives, it should be made clear that it will continue to be prescribed on the NHS until the NICE ruling is published.

"It is frustrating for doctors, especially when you don't have another option. Without this drug some patients could be dead in a few years," he says.

Dr Mahmood also believes that the process of assessing new drugs needs to be overhauled and speeded up for the sake of patients.

"NICE is a good idea but it needs to move swiftly," he adds.

Priority should be given to drugs which can save lives and the views of the specialists must be taken more seriously, he says.

But for Ann Tittley, the dispute is all about cash.

"It's money really, that is the be-all and end-all as far as I can see."

"After all this, I just hope Glivec is going to work," she adds.