How NICE supports its guidance Julie Royce, Associate Director, Implementation Support Learning about NICE day 3 February 2016 Evidence Search, formerly NHS Evidence Search, is a part of the NICE Evidence Services suite of resources. Explain that they are not going to be looking at everything about NICE in this session and that the focus is on Evidence Search.

Not so simples! Think back to a few years ago. When mum and dad wanted you to tidy your room because they said it made it easier to find things – you believed them didn’t you? You just happily complied? Or think about one of your lecturers – he or she is experienced, knowledgeable, authoritative.. Why shouldn’t you just follow their recommendations? This picture shows sums up the complexity of behaviour change in a 3 part model called the COM-B system which shows you how behaviour occurs as an interaction between three necessary conditions. Then there is the implementation science. Doesn’t really simplify things unfortunately as current science suggests that some interventions work some of the time but none all of the time. Those that do work tend to have quite modest effects – a key message is to be multi-faceted in your approach. Implementation science – some interventions work some of the time – none work all of the time - individual modest effects – be multi-faceted

NICE implementation strategy Provide guidance in the right format to the right people at the right time Influence the health and social care system to provide a supportive environment – both nationally and locally Provide practical support Share good practice Evaluate National support for local action Bullet 6 – in summary these are components of our strategy which we can provide nationally to support and complement local action which will differ in accordance with local circumstances.

How does NICE deliver the strategy? We improve accessibility through digitisation and NICE pathways and social media We work with key national partners We facilitate local problem solving We provide tools We provide a local practice collection on our website We endorse and publicise relevant support resources We collect and share published data to assess impact and inform updates Bullet 3 – for example by working with policy makers and system influencers at the national level. Or through our field team of local implementation consultants working with local organisations to facilitate local problem solving. Bullet 3 – we provide tools which help people to plan for the financial and resource impacts and a baseline assessment tool which helps people to take a snapshot of current practice and to inform clinical audit priorities. We also provide some online learning resources, health technology implementation advice and educational podcasts. Bullet 4 – we share good practice either through our local practice collection on the NICE website or by endorsing resources produced by other organisations. Bullet 5 – we collect published data to assess what the impact of NICE guidelines is and to inform updates of our guidelines. NICE ONE!

Tips and pointers for later At what level is the challenge? Eg team, individual, organisation, system What are the barriers? Consider resource impact, think behaviour change theory – eg beliefs, fear, lack of knowledge, confusion, myths, system conflicts What are the enablers? Consider support resources, education, peer support/opinion formers, shared learning, clinical audit How to achieve high quality healthcare? Read our book - available from Amazon

Stop me and ask me at lunchtime Thank you for listening and bon appetit!