A NICE perspective

Professor Carole Longson

Director

Centre for Health Technology Evaluation

NICE

Areas to cover

• Short history of NICE

• Our principles and

processes

• Important new

developments for NICE

NICE – established 1999

The National Institute for Health and

Clinical Excellence (NICE) is the

independent organisation in the UK

responsible for providing national

guidance and setting standards for

the NHS and the wider public health

community on the promotion of good

health and the prevention and

treatment of ill health.

What is NICE

• Funded directly by Government

• Accountable to the Secretary of State for Health

‘The Institute shall perform such functions in

connection with the promotion of clinical excellence and with the efficient use of available resources in the health service as the Secretary of State may direct’

Our remit has expanded

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20

40

60

80

100

120

140

160

180

2000/1 2001/2 2002/3 2003/4 2004/5 2005/6 2006/7 2007/8 2008/9 2009/10 2010/11 Mar-Oct 2011

Technologies

Clinical guidelines

Interventional procedures

Public health

Quality and outcomes

framework (QOF)

NHS Evidence accreditation

Quality standards

Medical devices

Diagnostics

Inclusive processes

Appraisal

Consultation

Guidance

Update

Evidence

review

NICE Guidance

Independent

Assessment

Technology Sponsors

Guidance

Independent Advisory

Body

Patient & professionals

Public consultation

Topic experts

A responsive system

2000

First review of methods

Appeal rights to all consultees

2003

Second review of methods and process

WHO review positions NICE as ‘world leader’

2006

Third review of methods and process

Faster appraisals: new single technology appraisal process

2009

3 judicial reviews largely validate current approach End of life protocol

Kennedy value study

Scientific advice service

PPRS

Example Technology Appraisals

The value proposition

Value

Well constructed

evidence base

Improved health

outcomes

Competitive Price

A value for money approach

Probability of

rejection

Cost per QALY (£’000)

10 20 30 40 50

0

1

Technology Appraisal Recommendations

Decision Recommendations

Yes 276 (63%)

Optimised 83 (19%)

Only in research 24 (5%)

No 55 (13%)

Breakdown of all decisions contained in published NICE Technology

Appraisals 1–236 (January 2000 to October 2011)

Note: 6 withdrawn recommendations and 10 non-submissions are not

included

NICE Quality Standards

An Important New Development

• NICE Quality Standards represent

key elements of best practice

• Meeting NICE Quality Standards will

help improve national outcomes and

inform local practice and data

collection

• NICE Quality standards underpinned

by evaluation of clinical care that is

good value for money

Unsafe Substandard Adequate Good Excellent

NICE quality standards

Standard of services

Proportion of services

Registration requirements

Standards define high quality care

NICE Pathways A new way of presenting NICE Guidance

• NICE pathways bring

together all support from

NICE

– Access to a comprehensive

evidence base

– Underpinning guidance

– Quality standards

– Support tools

– Costing/commissioning tools

• This facilitates access to

commissioning across a

whole pathway

Summary The goal for NICE

New functions beyond our

current guidance role

Adapt to changing priorities

Play our part in the evolving life sciences industry

strategy

Present our work in new ways

Responsive,

adaptable,

accessible and

trusted