The National Institute for Health and Care Excellence (NICE) is an independent organisation set up by the Government in 1999, to tackle the variation in availability and quality of healthcare in the NHS. NICE is funded by and accountable to the Department of Health and Social Care.
NICE provide technology appraisals, clinical guidance and quality standards on treatments and care. This consists of recommendations on how to best identify, refer, diagnose, treat and manage patients based on the best evidence available. NICE is internationally recognised for its scientific robustness and the quality and accuracy of its recommendations.
What NICE clinical guidelines are used for
NICE clinical guidelines are intended for health and social care professionals, commissioners, patients and carers to help them make informed decisions on the appropriate treatment and care.
When put into practice, NICE guidelines have the potential to effectively target health and care resources to significantly improve patient outcomes, in line with the best available evidence of clinical and cost-effectiveness. Although healthcare professionals and commissioners are not legally obliged to follow NICE guidelines, they are expected to take them into full account when making decisions on treatment and care for patients.
How NICE clinical guidelines are developed
The Department of Health and Social Care decides which topics NICE should develop clinical guidelines on. For each guideline, NICE establishes a guideline development group which comprises of healthcare professionals, researchers, patients and carers. The group produces a draft scope which sets out what the guideline will and will not cover. Patients, carer organisations and other relevant stakeholders are consulted with during this process.
The guideline development group then decide on a list of questions based on the scope. These questions are used to find relevant research evidence. Based on the quality and relevance of this evidence the guideline development group make their recommendations. A draft guideline is published and stakeholders are invited to comment during a public consultation.
Following the consultation period, the guideline development group reviews the comments received, and amends the guideline if considered appropriate. The final changes are then approved by NICE and published on the NICE website.
How decisions are made in the devolved countries
NICE guidelines officially only cover England. Decisions on how they apply to Wales, Scotland and Northern Ireland are made by the devolved administrators, who are often involved and consulted with in the development of NICE guidelines. NICE also has specific agreements in place to provide certain services and products to Wales, Scotland and Northern Ireland.
In Wales, clinical guidelines produced by NICE apply, although decisions on medication are often subject to approval by the All Wales Medicines Strategy Group (AWMSG).
In Scotland, the Scottish Intercollegiate Guidelines Network (SIGN) is responsible for developing evidence based clinical practice guidelines. A separate body, the Scottish Medicines Consortium (SMC) produces guidance on medicines. Both bodies fall under Healthcare Improvement Scotland (HIS), which was established in 2010 to support the Scottish Government’s Healthcare Strategy.
In Northern Ireland, the Department of Health (DoH) review guidelines produced by NICE and decide whether it is relevant to Northern Ireland. When guidance is not relevant the DoH advises on any changes which need to be made, majority of NICE guidance, are however approved by the DoH.