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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 - PowerPoint PPT Presentation
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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
NICE and NHS Evidence
Evidence – guidance – shared learning
This is how we add value
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 topicsPublished 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 2012Pilot 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
NHS OUTCOMES FRAMEWORKDomain 1
Preventing people from
dying prematurely
Domain 2Enhancing the quality of life for
people with LTCs
Domain 3Recovery
from episodes of ill health /
injury
Domain 4Ensuring a
positive patient
experience
Domain 5Safe
environment free from avoidable
harm
NICE Quality Standards (Building a library of approx 150 over 5 years)
Commissioning Outcomes Framework
Commissioning Guidance
Provider payment mechanisms
Commissioning / ContractingNHS Commissioning Board - Specialist services and primary care
GP Consortia – all other services
1
2
3 4
7
Duty of quality
Du
ty o
f qu
ality
Du
ty o
f qu
ality
tariffstandard contract
CQUIN QOF
5
6
Duty of quality
NHS OUTCOMES FRAMEWORKDomain 1
Preventing people from
dying prematurely
Domain 2Enhancing the quality of life for
people with LTCs
Domain 3Recovery
from episodes of ill health /
injury
Domain 4Ensuring a
positive patient
experience
Domain 5Safe
environment free from avoidable
harm
NICE Quality Standards (Building a library of approx 150 over 5 years)
Commissioning Outcomes Framework
Commissioning Guidance
Provider payment mechanisms
Commissioning / ContractingNHS Commissioning Board - Specialist services and primary care
GP Consortia – all other services
1
2
3 4
7
Duty of quality
Du
ty o
f qu
ality
Du
ty o
f qu
ality
tariffstandard contract
CQUIN QOF
5
6
Duty of quality
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
www.nice.org.uk
NHS Evidence – including Evidence Hubs
www.evidence.nhs.uk
