Andrew Dillon

Abstract

Building on a pre-existing tradition, in the United Kingdom, of using evidence to inform individual treatment decisions and resource allocation, the development of NICE guidance is based the principles of scientific rigour, transparency, inclusiveness and contestability. 

It relies on a network of committed external experts to help assess and interpret evidence, together with the active engagement of stakeholders, working with independent advisory bodies in managed space for engagement. However well developed, for guidance to have an effect, it needs to be engineered into the day to practice of health professionals and those who manage the environment in which they work. Since 2004, alongside the four main guidance programmes, NICE has invested around 10% of its resources in supporting the implementation of its guidance. Informing national standards for the NHS in England and through different mechanisms in Wales, Scotland and Northern Ireland, NICE guidance has had a major impact on the quality and consistency of care. Despite this, some of the guidance produced has not been uniformly adopted and more needs to be done by local health communities to take full advantage of it. NICE needs to look at what it is producing and how it presents its recommendations to make them as accessible as possible.

The initiatives announced in the recently published report by Ara Darzi, which anticipate a significant increase in the reach and impact of NICE, offer the ideal platform for the Institute to develop and change to achieve its full potential, and for the wider health system to take advantage of it.