The future for NICE

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The future for NICE

• Andrew Dillon
• Chief executive

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Seems like only last week
NICE is at the forefront of international
health-care reform
The Economist
July 31-August 6 1999 p 22
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More recently..
"NICE may prove to be one of Britain's greatest
cultural exports, along with Shakespeare,
Newtonian Physics, the Beatles, Harry Potter and
the Teletubbies"
The Triumph of NICE Richard Smith, Editor BMJ
July 2004
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Actually, this is all weve ever want to do

• To get us all to healthy, happy retirement!
• Through preventive and treatment guidance, we
  advise on optimal approaches to health and health
  care
• And to help the NHS make the best use of its
  money

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NICE guidance 2000-2008
Public health
Interventional procedures
Clinical guidelines
Technology appraisals
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The future

• Growth (planned, at least) over the next 3 years
• New functions and expanded programmes
• A central role in setting standards
• More support for implementation
• A ground-breaking initiative NHS Evidence
• New consultancy services

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Guidance programmes

• Expanded technology appraisal programme
• New pathway for process for organising national
  evaluation of diagnostics and devices
• Expanded clinical guidelines and public health
  programmes
• Maintain the interventional procedures programme
• New diagnostics appraisals
• New quality standards

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NICE guidance 2009-2011
Quality standards
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Quality standards

• Concise, evidence-based and measurable
• Meaningful for patients, commissioners and health
  professionals
• Priorities to be set by a National Quality Board
• A library, covering the main causes of morbidity
  and preventable early mortality
• Space for local organisations to set their own
  ambition for quality improvement, alongside
  national standards
• First standards available in late 2009/early
  2010, through NHS Evidence

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Methods development

• We have produced almost 600 sets of guidance,
  across 4 main programmes, over 10 years
• Weve been subject to only 3 judicial reviews in
  that time
• and we have been asked to make just 2 (not
  unimportant) changes give more consideration to
  our duties under anti-discrimination legislation
  and to release executable versions of economic
  models
• Continual review and development of our methods
  and processes is a defining characteristic of how
  we work

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Supporting implementation

• Do more to measure the impact of our work by
  investing in additional analytical capacity
• Contribute to the development of indicators to
  help the NHS measure the quality of its services
• Extend the range of our implementation support
  materials
• Build implementation in Wales and Northern
  Ireland
• Improve access to best advice through NHS Evidence

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The future NHS Evidence
Clinical
Commissioning Improvement

• Service guidance
• Tools models
• Care pathways
• Indicators metrics
• Improvement information

• Guidelines
• Systematic Reviews
• Other synthesises content (summaries overviews)

• Primary research and ongoing trials

Social care
E-Learning Education

• Social care evidence and guidance

• On-line learning modules

Drug Technologies
Public Health

• Prescribing safety information
• Technology appraisals
• Significant new drugs
• Devices, diagnostics IP guidance

• Public Health guidance
• Systematic reviews
• Primary research

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Consultancy services

• Scientific advice service for technology
  developers
• Interpretation of NICE technology appraisal
  methods guidance
• Clinical research study and economic evaluation
  design
• Aim is to reduce uncertainty in evaluating new
  treatments a win-win for NICE and the healthcare
  industries
• International advice on health policy and
  practice
• Governments and agencies outside the UK are
  interested in what we do some of our methods and
  processes are transferable
• Working with selected UK and international
  partners to put together tailored packages of
  support
• Aim is to improve decision-making capacity
  mainly in low and middle income economies

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And wed like to move the debate on too
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More recently..
When NICE first started to flex its muscles in
1999, the drugs industry would love to have
exported it, preferably somewhere like Mars.
Ten years later, the influence of NICE, far
from being blunted, is beginning to spread. Its
methods and organisational model have become
something of a beacon to governments wrestling
with the issues of efficacy and fairness in
healthcare delivery.
NICE goes global Nigel Hawkes BMJ January 2009
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