NICE in a changing world

1. NICE in a changing world National Leading Improvement for Health and Well-being programme 12 May 2011 Gillian Mathews Implementation consultant

2. Welcome! • Purpose of session • to improve understanding of NICE and our guidance • to look at how evidence based decision making can contribute to improved efficiency and effectiveness • to look at how NICE’s role is developing for the future

3. What is NICE? The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of goodhealth and the prevention and treatment of ill health ...and soon to include social care too

4. This is what we do NICE and NHS Evidence Evidence – guidance – shared learning

5. This is how we add value Independence, objectivity and transparency.

6. Core principles of all NICE guidance • Comprehensive evidence base • Expert input • Patient and carer involvement • Independent advisory committees • Genuine consultation • Regular review • Open and transparent process.

7. A short history of NICE products Interventional Procedures Primary care indicators Quality standards Clinical guidelines Public health

8. Who writes the guidance?

9. What do we mean by ‘evidence?’ • There is a lot of data about this? • Other people are doing this? • There is a research study which shows this is effective? • There is a significant body of research which shows that this is effective?

10. Example - Promoting physical activity for children Consultation Documents • Review 1 - Epidemiology • Review 2 - Quantitative correlates • Review 3 - Qualitative correlates • Review 4 - Interventions for under eights • Review 5 - Active travel interventions • Review 6 - Interventions for adolescent girls • Review 7 - Family and community interventions • Review 8 - Active play • Review 9 - Economic evidence • Cost effectiveness analysis

11. Why use the best available evidence? • To reduce variation • To reduce inequalities • To improve quality of service provision • To reduce waste • To ensure the best use of resources

12. ...and if you can’t find what you need... www.evidence.nhs.uk

13. Search 200 sites in one click...

14. Why use the best available evidence? • To reduce variation • To reduce inequalities • To improve quality of service provision • To reduce waste • To ensure the best use of resources

15. Changes ahead... • Change from NHS Special Health Authority to non-departmental government body (NDPB) • Change of name – National Institute for Health and Care Excellence (NICE) • Brief to include social care guidance and standards • Changed role under proposals for Value Based Pricing

16. Quality Standards topics Published to date • Stroke • Dementia • Prevention of venous thromboembolism • Specialist neonatal care • Diabetes in adults • Depression • Chronic kidney disease • Glaucoma Currently in development • COPD • Breast cancer • Chronic heart failure • Alcohol dependency • End of life care

17. Future quality standards • Acute chest pain • Antenatal care • Asthma (including children and young people) • Bipolar disorder in adults • Bipolar disorder in children and adolescents • Colorectal cancer • Diabetes in children (type 1 and type 2) • Diagnosis and management of hepatitis B, all ages • Drug use disorders (over-16s) • Epilepsy in adults • Epilepsy in children • Falls in a care setting • Head injury • Hip fractures • Intrapartum care (management and care of women in labour and delivery) • Intravenous fluid therapy in hospitalised adult patients • Lung cancer • Management of myocardial infarction • Management of ulcerative colitis • Meningitis in people under 16 • Migraine/headache (over 12 years of age) • Nutrition in hospital, including young people • Osteoarthritis • Ovarian cancer • Postnatal care • Pressure ulcers • Prostate cancer • Pulmonary embolism • Reflux disease (gastro-oesophageal reflux disease) • Safe prescribing • Schizophrenia

18. Social Care Standards Social care – formally added to NICE’s remit in April 2012 Pilot of 2-3 social care topics for standard development in 2011: • Workshop with key group in June 2011 to inform the model • Evidence base and underpinning ‘guidance’ is crucial • Topics likely to bridge the health and social care interface

19. Outcomes Framework and Standards

20. Commissioning Outcomes Framework Commissioning Outcome Framework is an accountability framework for GP commissioning consortia to: • allow the NHS Commissioning Board to identify the contribution of consortia to achieving priorities for health improvement • enable commissioning consortia to benchmark their performance and identify priorities • provide the potential for some indicators to be linked to quality premium payments

21. NICE pathways NICE pathways bring together all related NICE guidance, including Quality Standards and implementation support tools

26. Summary • Purpose of session • to improve understanding of how NICE and our guidance • to look at how evidence based decision making can contribute to improved efficiency and effectiveness • to look at how NICE’s role is developing for the future

27. Contact us Gillian Mathews - Implementation Consultant: North gillian.mathews@nice.org.uk Visit the NICE website – including NICE Pathways www.nice.org.uk NHS Evidence – including Evidence Hubs www.evidence.nhs.uk