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

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

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

This is what we do Evidence assessment and interpretation Economic evaluation and resource impact assessment Pathways, guidance and standards Web access for decision support and e-learning NICE and NHS Evidence Evidence – guidance – shared learning

This is how we add value Better outcomes for patients Knowledge for professionals and patients Effective use of NHS resources Access to the NHS market Our purpose is to improve the quality and productivity of clinical practice, public health and social care Independence, objectivity and transparency.

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.

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

Who writes the guidance?

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?

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

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

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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

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

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

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

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

Outcomes Framework and Standards

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

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

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

Contact us Gillian Mathews - Implementation Consultant: North Visit the NICE website – including NICE Pathways NHS Evidence – including Evidence Hubs