The National Institute for Health and Care Excellence (NICE) is the independent organisation that provides national advice to the NHS and local government on the promotion of good health and the prevention and treatment of ill health.
NICE offers a range of guidance and other evidence-based products to the NHS, social care, local government, and the wider public health community (see Figure 1), including:1,2
- public health guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities, and the wider public and voluntary sector
- clinical practice guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS
- health technology guidance on the use of new and existing medicines and other treatments, diagnostics, and surgical procedures including interventional procedures
- quality standards against which the people who use the NHS can measure the quality of care
- recommendations for amending and replacing clinical indicators in the quality and outcomes framework component of the GMS contract
- access to evidence to support those working in healthcare, public health, and social care through NHS Evidence.
|Figure 1: The benefits of NICE|
QOF=quality and outcomes framework
|Figure 2: NICE implementation consultants by region|
QOF=quality and outcomes framework
Alongside producing guidance, NICE has a comprehensive programme to support implementation of the recommendations and to help the NHS to meet the quality, innovation, productivity, and prevention challenge, which has become increasingly important. The aims of the implementation strategy are to:
- motivate and encourage change in practice by working with other organisations/systems within the NHS and partner organisations
- provide practical support
- monitor uptake of the recommendations to inform future work.
As part of the practical support, NICE produces a range of implementation support tools, some of which offer generic advice and some of which are topic-specific. These can be found on the NICE website under a section called ‘putting guidance into practice’
NICE field team
To provide a regional focus for implementation support, NICE also employs a team of seven implementation consultants (see Figure 2, above). Acting as the local face of NICE, the consultants offer:
- strategic advice to help senior management teams in the NHS and local authority organisations implement NICE guidance
- help to solve problems by sharing examples of how other organisations in the area approach implementation and work in partnership
- updates and advice on how to use the NICE implementation tools
- the opportunity for clinicians and managers to provide feedback on NICE and its resources, and to make suggestions for improvement
- regular feedback to NICE and its board from local engagement activities.
Role of implementation consultants
The implementation consultants have a wealth of experience in supporting implementation and service improvement and come from a variety of backgrounds including hospital, general practice, and clinical network management; commissioning; and audit.
To ensure the team focuses and deploys its resources effectively, we develop an engagement strategy of themed visits for 6-month periods of time. When planning our visit strategy we take into account:
- changes in the environment, such as new national initiatives and organisational structures
- evaluation and feedback from the current visit programmes
- forthcoming NICE guidance
- new NICE work programmes and outputs.
We are currently (April to September 2010) meeting with acute trust medical directors and chief operating officers of primary care trust (PCT) provider services to discuss how NICE guidance and implementation support tools can help their organisations to: improve the quality of services to patients; demonstrate the quality and cost effectiveness of services to commissioners; and meet the requirements of regulators. As part of these discussions we have highlighted a new baseline assessment tool that has been produced in response to local requests for a resource that prevents duplication of local effort and makes it easier for organisations to review current activity in relation to NICE guidance and then plan any required actions (see www.nice.org.uk/guidance/CG101/BaselineAssessment/xls/English).
As financial pressures and affordability are becoming an increasingly important part of local decisions we have also been signposting a list of:
- cost-saving guidance that, when implemented, will potentially save millions of pounds across the NHS
- optimal practice reviews that highlight where in NICE guidance we recommend ceasing practice because it is ineffective.
In addition, we are running workshops for local authority Health Overview and Scrutiny Committees to improve their understanding of NICE and the value of using NICE guidance to help them frame questions for use in their role as scrutinisers of local services and investment decisions. Finally, as part of the themed programme of visits, we are meeting with acute trust executive and senior nursing teams to demonstrate how NICE guidance can help nurses improve the quality of care they provide to patients, and how use of the support tools can aid local guideline implementation.
From October 2010 until the end of March 2011 we hope to meet with:
- heads of children’s services in local authorities
- directors of human resources and occupational health leads in mental health trusts
- PCT and acute trust medicines management networks
- communication network leads
- cancer networks
- medical schools.
If you work in or are connected to any of these organisations or networks and would like to be involved in the above meetings, then please let us know. Further details of these campaigns will be found in future issues of NICE News, our e-newsletter, which you can sign up to receive at: www.nice.org.uk/registration/index.jsp.
Support for you
On top of our formal engagement strategy we also respond to a variety of requests for further input from the organisations we engage with. These requests include:
- speaking at local conferences, such as audit and effectiveness events
- advising health economy wide clinical effectiveness groups on strategies for implementation and assurance of compliance with guidance
- providing answers to queries or updates about NICE and its programmes to networks such as national prescribing centre associates.
We are very happy to provide whatever level of support is needed (see the case study, Box 1). If you would like any more information or would like to find out about how NICE guidance and tools can help you in your work, please feel free to contact your local implementation consultant.
|Box 1: Case study—providing support|
A NICE implementation consultant was invited by a recently appointed PCT NICE Implementation Lead to run a 2-hour session for the NICE Implementation Steering Group, which included representation from both primary care and the community health services. The aim was to raise understanding of NICE, the implementation support tools, and of new programmes and resources that can support them with the local quality, innovation, productivity, and prevention challenge.
There was a lot of interest in how easily NHS Evidence could help clinical and managerial professionals find high-quality and up-to-date information from accredited sources to support commissioning, clinical, and non-clinical decisions. The PCT is now looking at downloading the search toolbar onto their intranet to provide direct and quick access for staff. Following on from the meeting, the NICE implementation consultant sent the group an article that they can use to promote the service and to explain the appearance of the search toolbar.
As the NICE Implementation Lead wants to promote and support effective use of the implementation tools locally, the NICE implementation consultant has been asked back to provide more details and a demonstration of how to use them.
Speaking about the visit, the NICE Implementation Lead said: ‘Feedback from the group was excellent. Members found it very interesting and informative.’
PCT=primary care trust
- NHS Choices website. Health regulators. National Institute for Health and Care Excellence. Available at: www.nhs.uk/NHSEngland/thenhs/healthregulators/Pages/nice.aspx (accessed 13 July 2010).
- NICE website. About NICE. Available at: www.nice.org.uk/aboutnice (accessed 13 July 2010).G