nice in a changing world

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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

...and if you can’t find what you need...

www.evidence.nhs.uk

Search 200 sites in one click...

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

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

gillian.mathews@nice.org.uk

Visit the NICE website – including NICE Pathways

www.nice.org.uk

NHS Evidence – including Evidence Hubs

www.evidence.nhs.uk

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