A decade has past since the European Medicines Agency approved Xyrem for use in the European Union. Four years have passed as Jacky, a British and E.U. citizen, has been repeatedly denied access to that same drug by NHS England. Why? It's shockingly simple. A chronic, neurological condition like narcolepsy should be managed by specialist staff in specialist centres who are backed with clinical commissioning policies developed by the central body that is NHS Specialised Services. Yet, a decade from licencing, decisions around the provision of this drug are taken via Clinical Commissioning Groups across the UK who routinely ignore the advice of specialist neurologists as they blindly follow the only policy open to them, the "Individual Funding Request"or "IFR". The IFR requires an individuals "exceptionality" and the "cost-effectiveness" of the drug to be taken into account. Both of these mean that an IFR is a veritable tail-chasing and ultimately money wasting exercise for both patient & clinician. So, whilst people with narcolepsy may well be judged as unexceptional and not worth the investment, this medicine has been licenced in the European Union for ten years and for NHS England not have a clinical commissioning policy is unforgivable.