NHS Evidence….

…..and the NHS/HE partnership

Dr Gillian LengChief Operating Officer, NHS EvidenceDeputy Chief Executive NICE

NHS Evidence – the concept

Quality assessment

Educational links

Q &A

Areas to cover

Darzi report: High quality care for all

The report stated that:

‘NICE will manage the synthesis and spread of

knowledge through NHS Evidence – a new

single portal through which anyone will be able

to access clinical and non-clinical evidence and

best practice, both what high quality care looks

like and how to deliver it. Greater clarity on

standards, and where to find them, will support

the commissioning and uptake of the most

clinically and cost-effective diagnostics,

treatments and procedures’.

The challenge of multiple sources of information

Bandolier

BNF

CKS

Cochrane

DARE

DUETs

Department of Health

HTA

Healthcare Commission JAMA

Map of Medicine

Economic Evaluation Database

NICE

PubMed

SIGN

BMJ

NHS EvidenceNHS Evidence

NHS Evidence will sort, sift and prioritise information according to user needs

Key principles for NHS Evidence

Comprehensive access to variety of external sources …

… but not directly generating new content

Independent accreditation process to highlight high quality information …

… focussed initially on summarised evidence (e.g. guidelines)

Highlight ongoing clinical trials …… and still make primary research evidence available

Principally designed for professionals…

… but also available to patients and the public

As easy and simple to use as Google…

… presenting results in logical categories

Use existing networks for on-going marketing and communication …

… and recognised as “more than just a website”

NHS Evidence

Categories of information in NHS Evidence

Clinical Evidence*

• Guidelines

• Systematic Reviews

• Other synthesises content (summaries & overviews)

• Primary research and ongoing trials

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* Including patient safety

Drug & Device Information

• Prescribing & safety information

• Technology appraisals

• Significant new drugs

• Devices, diagnostics & interventional procedures

Practical Support*

• Service guidance

• Tools & models

• Care pathways

• Indicators & metrics

• Improvement information

• Local examples & tools

* For example, for commissioners

Non-clinical Information

• Social care information – assured by SCIE

• Public health information – evidence and practical support

Functionality to be included in NHS Evidence

In• Efficient search facility – as

easy and simple as Google

• Categorised and prioritised content

• Opportunity to set-up a personalised homepage

• Alert system to highlight key new information

• Integration into NHS and third party IT systems

• Complex searching for specialist researchers

Out• Dedicated Q&A service

• Wiki for medical knowledge

• Internet searching for content (e.g. blogs, video clips etc.) that aren’t quality assured

• Discussion board (covered by CfH)

• Dialog service with patients/public (covered by NHS Choices)

The Virtual Health Library - Brazil

Health Professionals Portal - Singapore

World Health Organisation, Health Evidence Network - Europe

Health Insite - Australia

DUODECIM - Finland

Rolling out NHS Evidence• Full development of NHS Evidence will take

several years – to set up systems for clinical

engagement and to organise and sort the vast

range of information sources

• Initial launch of NHS Evidence in April 2009

will include:

– A fast, comprehensive search function for

clinical and non-clinical information

– Access to a resource collating information

on new drugs to support commissioners

– A new NHS Evidence homepage,

Oct 08

Nov

Dec

Jan 09

Feb

Mar

Apr

May

Jun

Jul

Aug

Sep

Oct

Nov

Dec

2010

2011

2012

Bandolier

BNFCKS

Cochrane

DARE

DUETs

Department of Health

HTA

Healthcare Commission

JAMA

Map of Medicine

Economic Evaluation Database

NICE

PubMed

SIGN

BMJ

Sources Quality

Advisory Committee

SpecialistLibraries

Technology

NHS Evidence

Users and stakeholders

Clinicians etc

Organisations

IT - websitesNeLM

Quality – key challenges

Advisory Committee:– Defining best practice

guidance– Accrediting key sources of

information– Directing search returns?

Specialist libraries:– Annual evidence updates– Identifying significant new

information

The NHS Evidence accreditation scheme

NHS Evidence Accreditation

Scheme

Transparent and based on standardised criteria and processes

Unbiased with oversight by an independent Advisory Board

Focused on ‘guidelines’ sources of evidence

Based on the process used to develop evidence

Kitemark will become well-known and recognised

Sources will be accredited, rather than individual articles

Key aim: to identify trusted sources of

information and set best practice

standards

Draft criteria – based on AGREE

• Scope and process – clearly defined

• Stakeholder engagement policy

• Rigorous development process –

including systematic searching,

inclusion/exclusion criteria etc

• Recommendations clearly presented

• Applicability considered

• Reliable – absence of bias

“Change is not made without inconvenience, even from

worse to better”

Richard Hooker,1554-1600

Getting evidence into practice

The NICE implementation programme

Four key aims - to:

• Ensure effective dissemination

• Motivate and inspire

• Provide practical support

• Evaluate impact and uptake

Local leadership is essential

Initial challenges for NICE

Level? Profession? Influence?

CPD/lifelong Doctors Curriculum/standards

Postgraduate Nurses Teaching materials

Undergraduate Allied health professions etc

Exams

School Environmental health, teachers, etc,etc

Self-directed learning

Progress to date

Motivating/embedding

• CPD links via Royal Colleges

• Input to Tomorrow’s Doctors

• Exam questions at Royal Colleges based on NICE guidance

Practical support

• Topic specific modules commissioned via BMJ Learning

• Undergraduate education package on use of evidence

• Future – eLearning repository

Next steps

• Build on Specialist Libraries

work programme and NLH

activities

• Continue to liaise with key

stakeholders

• Roll out Release 1!

&