Untitled Document

Combined Annual Report and Accounts

1999/2000

National Institute for Clinical Excellence

Contents:

Section One: Annual Report and Commentary

  1. Introduction.
  2. Establishing NICE.
  3. Programmes and Objectives.
  4. Challenges and Achievements.
  5. Looking to the Future.


Section Two: Annual Accounts 1999/2000

1999/2000 Accounts.

Notes:

  • Section 1 of this document has been designed for web publication.
  • Section 2 has been designed as a paper document and will be incorporated into an electronic publication as PDF file. (Portable Document Format).

Section One: Annual Report and Commentary

1. Joint Introduction to Annual Report and Accounts by the Institute's Chair and Chief Executive.

Click here to listen to introduction

Sir Michael Rawlins

Hello, I am Michael Rawlins, Chairman of the National Institute for Clinical Excellence - or NICE as it is now universally known. With me is Andrew Dillon, the Institute's Chief Executive.

In this Annual Report we have reviewed the Institute's progress on its first full year. We have looked at its work, its development and its accounts. As part of NICE's commitment to the use of modern information technology, this report is published on our web site, first, though, Andrew and I would like, briefly, personally to introduce the Institute and our Annual Report.

Andrew Dillon

Thank you. This has been an exciting and challenging first year for everyone involved in NICE. Last year on the 1st April 1999 the Institute was launched by Frank Dobson as part of the Government's commitment to delivering a modern and dependable NHS. For the first time, the NHS had a national organisation dedicated to offering to patients and professionals, clear and authoritative evidence based guidance on clinical practice. A world first, NICE was described by The Economist as being at the forefront of health care development internationally.

Sir Michael Rawlins

From the beginning we emphasised that the Institute's guidance would cover clinical practice right across the spectrum of care, in the community and in hospitals. We would be looking at individual health technologies such as medicines, surgical procedures and devices for example replacement hip joints; and that we would also be producing guidance on the clinical management of specific conditions. We all recognised that we would be offering both the NHS and patients a new service. . . . a service that we intended should earn, and retain, the confidence and respect of the community as a whole.

Andrew Dillon

Well, in pursuing this goal we had two guiding principles: - firstly our advice must be based on a rigorous analysis and assessment of all the available evidence and secondly, it must encompass both clinical and cost effectiveness. We also wanted to ensure that the Institute's guidance whilst being robust and authoritative was directly relevant to contemporary clinical practice.

Sir Michael Rawlins

One of the best ways to see how the Institute has met our goals is to surf our Annual Report. Clearly the short review of the year provide highlights, but I would also recommend the sections of the report that look in more detail at why the NHS needed NICE, how it was established and the Institute's aims for the next 3 years. Andrew is there anything that you would particularly draw our attention to?

Andrew Dillon

We should start with the real stars, the people who have put so much into this first year. Our staff are, of course, at the top of the list, but right there with them are the people, from inside and outside the NHS, without we simple couldn't operate. I'm thinking, in particular, of the members of the Appraisal Committee, who give us so much of their time each month - and I should add thanks here to, in advance, the newly appointed members of the Guidelines Advisory Committee. And then there are the academic teams at Southampton, Birmingham, Sheffield and Newcastle and York who have really worked hard to tight deadlines to produce the assessments that underpin our technology appraisals. Our Partners Council whose advice is so important to us and the patient and organisations who keep us in touch with the day to day reality of health care. And we are very conscious of the considerable effort that manufacturers and their representative organisations have put into providing us with evidence of their products contribution to patient care. We have also received much help and advice from our colleagues at the Department of Health and the National Assembly for Wales, I am very grateful to them all.

And then there are our own staff. From just two of us in July last year to 28 now, we have been fortunate to find really committed and enormously hard working people. I would like to say a very big thank you to all of them. I am very proud of them all.

What matters most is that we do what we say we are going to do and that we do it to a consistently high standard. This is critical to gaining and holding onto the trust and confidence we are working for. I believe we delivered on our commitments last year. We built the organisation, created the systems, talked ourselves almost into the ground in order to explain what we are about. We set our technology appraisal programme and kept to it.

My biggest regret is that we were not able to move as fast as we wanted to in setting up the guidelines programme and in sorting out our approach to audit. But we didn't get our guidelines programme confirmed until November and, with so few people in the early days, we had to prioritise our work. And we have now done both.

NICE has changed for good the way the NHS approaches clinical practice. Change is often exhilarating but it is also unsettling and sometimes challenging. We have been conscious of the effect our work has had on organisations inside and outside the NHS and we have tried to be sensitive and considerate in the way we have worked with them. And where it seems that we haven't succeeded, we have recognised the alternative point of view. We have also tried hard to be open in our work as well as being open to good advice on how to go about our business.

On a personal note, I can say with great pleasure that it has been the best year of my NHS career.

Sir Michael Rawlins

Our achievement during the first year would have been impossible without the direct support of many individuals. Andrew has already paid tribute to our own staff, to members of our independent advisory committees, and to the evaluation teams in Southampton York, Sheffield, Birmingham and Newcastle.

I would like to express my own gratitude to three other groups. Firstly, the Institute's Senior Management Team under Andrew's leadership has been the driving force in implementing our programmes. Its members include Peter Littlejohns (Clinical Director), Anne-Toni Rodgers (Communications Director), Richard Jefferies (Acting Finance Director), Rod Taylor (Head of Appraisals) and David Pink (Head of Guidelines). Their commitment, drive and energy to the Institute has been extraordinary. Second, I am grateful for the support and hard work of the non-executive directors. They are all very distinguished in their own individual fields but they have thrown themselves into supporting the development of the Institute with the greatest enthusiasm. Finally, we would have achieved nothing without the help of a wide range of professional organisations including the Royal Medical and Nursing Colleges, numerous professional associations and of course the NHS itself.

Thank you.

2. Establishing NICE.

All health professionals want to give their patients the best possible care. However these same professionals across the world face two particular difficulties:

  • First, the pace of scientific and clinical discovery has become so great that it is impossible for individual health professionals to remain at the forefront of knowledge across the wide range of subjects with which they have to deal.
  • Secondly, the demand for health care - partly due to past successes, partly because of the emergence of effective new technologies and partly because we don't stop the use of less effective technologies - have exceeded the available financial and human resources.

As a result, every health care system in the world is struggling to find solutions to these problems and in the NHS these issues have resulted in patients experiencing unacceptable inequalities in the availability of care (so-called "post-code" prescribing), unacceptable variations in the quality of care, and wastage of both human and financial resources.

NICE has been established to help health professionals in the National Health Service give their patients the best possible healthcare within the resources available.

Further information can be found from:

3. Programme and Objectives

The National Institute for Clinical Excellence is a part of the NHS. It is a Special Health Authority that has been established to help health professionals in the National Health Service give their patients the best possible health care within the resources available. We produce for both the NHS and patients:

  • guidelines for the management of clinical conditions,
    (visit the Clinical Guidelines section of the web)
  • advice on when to refer to specialist care,
    (visit the Referral Advice section of the web)
  • guidance on the use of medicines, medical equipment and clinical procedures (visit the Technology Appraisals Section of the web)
  • information about and education in national audit, together with national audits

The Institute could not meet these challenging objectives without the support, advice and understanding of the following:

Further information can be found from:

  • A Guide to Our Work
  • Framework Document - which sets out the Institute's relationship with the Department of Health and the National Assembly for Wales.
  • The Institute´s Board Papers
  • The 'About NICE' section on this site
  • The press releases and news archives on this site

4. Challenges and Achievements.

Introduction.

1999 saw the Institute embark on its foundation year. Established as a Special Health Authority on the 1st April 1999, the first full time employees (the Chief Executive and the Communications Director) joined the Institute on July 12th.

The 1999/2000 business plan describes how the resources that were made available to the Institute, would be used to create the organisation and its capacity to undertake the work it had been asked to do. It sets the Institute in a national and international context, describing its contribution to the creation of a modern and dependable National Health Service.

The Institute's objectives in its first year of operation reflected the fact that we were dividing our effort between delivering our initial work programme and the task of building the capacity to enable us to do so. They also take account of the importance of creating partnerships with all stakeholders and effectively communicating information about both the Institute and the products of its work. The focus was on:

  • Establishing key partnerships
  • Undertaking an initial programme of technology appraisals
  • Determining a baseline position on audit funding
  • Establishing an initial programme of guidelines authoring
  • Communicating effectively
  • Developing the organisation
  • Preparing the future strategy
  • Developing resource management and financial control.

Review of 1999

The following review of the year highlights some of the successes, challenges and key milestones in our first year.

April, May, June 1999

  • The Institute became operational on April 1st 1999.
  • The Chairman and Board were appointed and work began on the strategic direction for the Institute and employing senior staff. (Professor Sir Michael Rawlins (Chair),Professor Parveen Kumar, Dr Suzanna Lawrence, Mrs Mary McClarey, Professor Tony Culyer (Vice Chair) and Mr Roy Luff.
  • The first public Board meeting was held in London in May.
  • The Partners' Council was established and at their first meeting focussed their attention to the issues of working with patients and their advocates in the development and dissemination of guidelines.
  • The Institute's first web site was launched and the Institute's principle of transparent working was established.
  • Funds were allocated to enable the Institute to operate. Much of the first year's allocation was locked into contracts for guidelines, audits and associated work that had been set before the Institute was established.
  • Recruitment of the Executive Directors began.
  • Design work began on the technology appraisals process, including a wide-ranging seminar.
  • A financial services contract was established with Lambeth Southwark & Lewisham Health Authority, managed by Richard Jefferies, Acting Finance Director
  • The following members of staff were transferred to NICE from the National Centre for Clinical Audit:
    • Julian Lewis - Communications Executive
    • Alison Salmon - Resource Development Manager
    • Nicki Bromwich - Audit Development Manager

July 1999

  • The Chief Executive and the Communications Director joined the Institute on the 12th July. Developing relationships with stakeholders and establishing the team and the organisation was an immediate priority.
  • Membership and terms of reference of the Senior Management team were approved by the Board at the public Board meeting held in Leeds and an outline communications strategy was presented to the Board.
  • The Institute was asked to conduct a Rapid Assessment of the flu' product zanamivir, (Relenza) in time for the 1999 flu season. A close working relationship with the manufacturer Glaxo Wellcome was established and work on the assessment commenced.

August 1999

  • The 6th August 1999 saw the Secretary of State for Health and the National Assembly for Wales ask the Institute to commence work on the first of its technology appraisal work programmes. The media interest in this launch was substantial and the programme was reported around the world.
  • At the same time the Institute described the process it intended to follow for its technology appraisals and released its interim guidance for manufacturers on preparing a submission for NICE.
  • We also contacted all the patient organisations, the professional organisations and the manufacturers who were involved with the technologies on the first work programme, inviting them to prepare submissions to inform our work.
  • In preparing the mailing the Institute had to develop systems and processes for sourcing information on these organisations and preparing mailings. We were not always successful. For example we sent our mailings via registered post and learnt that some stakeholders had not received their original letters. When we investigated we learnt that major organisations often don't sign for registered mail, the learning gained following feedback from stakeholders during this process was fed into the second work programme.
  • The Institute made contact with the Canadian Co-ordinating Office for Health Technology Assessment.
  • David Pink was appointed to the team as Head of Guidelines and Audit.

September 1999

  • The Institute was asked by the Secretary of State and the National Assembly for Wales to produce a set of Referral Advice to support referrals to specialist services.
  • Professor Sir Michael Rawlins gave the inaugural St Paul Healthcare Annual Lecture which enabled him to deal directly with topical and controversial issues such as rationing and affordability
  • In recognition that this was a new organisation and the processes it had established for technology appraisals were unfamiliar to some manufacturers the Institute began a series of one-to-one meetings with all of the manufacturers involved in the technology appraisals work programme.
  • Dr Rod Taylor joined the team as Head of Technology Appraisals and Professor Peter Littlejohns took up post as the Institute's Clinical Director.
  • Professor David Barnett was appointed as the first Chair of the Institute's Technology Appraisals Committee. The Committee was established and began its work.
  • and the Department of Health announced the appointments of Nigella Lawson and Frederick George as non-executive Board members.

October 1999

  • The 8th of October saw the Institute issue its guidance on zanamivir (Relenza) in the treatment of influenza. The launch to all general practitioners in England and Wales of this first piece of guidance was challenging and exciting, but was not without its disappointments.

We were disappointed that the media reported the Institute's recommendations to the Secretary of State before the process was complete. As the process was still ongoing the Institute was unable to comment on the speculation regarding the outcome of its work, despite the worldwide media interest. There were around 500 media contacts with the Institute and whilst we were unable to comment on the review we did take the time to explain to all callers how the Institute was established, how we conducted our work and how we involved stakeholders. The events were fully reviewed along with the media handling and helped inform the development of the Institute and its communications strategy.

On this occasion the Institute had been asked to prepare advice for the Secretary of State for Health and was pleased, to be asked to issue it direct to NHS. This presented us with the challenge of printing and distributing over 40,000 copies of guidance, with just a few days notice.

Feedback from January 2000 prescription data suggests that the NHS supported the Institute's guidance on zanamivir i.e. that this product should not be prescribed by the NHS. By the end of January 2000 (realistically towards the end of the 'flu season) the total number of NHS prescriptions written for zanamivir (Relenza) was 212.

  • NICE held a seminar involving clinicians, patient advocates and others interested in guidelines authoring. This marked the beginning of the design of our guidelines authoring process.
  • The public Board meeting was held in Cardiff . The Board approved the Standing Financial Instructions and Standing orders, reviewed the guidelines and audit work programme, a paper on organisational development and discussed the learning from the rapid assessment of zanamivir. A paper proposing Standing Orders for the Appraisal Committee, prepared by the Chief Executive, was received and the Board approved the standing orders of the Appraisal Committee. A paper prepared by the Chief Executive, proposing changes to the Interim Guidance to Manufacturers and Sponsors on the preparation of submissions, together with a proposal for delegation of powers to the Chairman and Chief Executive, was received and after discussion, the Board approved both proposals. Finally the Institute appointed Beachcroft Wansboroughs as solicitors to the Institute.
  • October also saw the arrival of 5 new team members
  • Diana Hewitt - Corporate Services Manager
  • Lucy Betterton - Communications Executive
  • Philippa Younas - Technology Appraisals Co-ordinator
  • Victoria Long - Administration Co-ordinator and
  • Kamla Patel who joined the team as Administration Assistant and was promoted later in the year to Projects Executive.

November 1999

  • The Secretary of State and the National Assembly for Wales confirmed the Institute's guidelines and audit work programme.
  • The Institute published and distributed several corporate publications including:
  • The Partners' Council discussed each of the 3 key areas of the Institute's work, Clinical Guidelines, Technology Appraisals and the promotion of Clinical Audit to support the strategic development of this work. The meeting was very constructive, with time being spent on mapping the individual and collective contribution of Council Members. A forward agenda was agreed, together with two issues on which Council members would be consulted outside the routine meetings (the handling of potential conflicts of interests and the Institute's approach to research and development).
  • Christine Sealy was seconded to the Institute to cover Nicki Bromwich's maternity leave. Christine brought her expertise in Guidelines and Audit from the College of Occupational Therapists.

December 1999

  • A key event in December was the Institute's inaugural Conference Clinical Excellence 1999. The conference was sold out weeks before and over 2000 delegates headed to Harrogate to participate in a programme of lectures and workshops with a national and International theme. The conference provided the Institute with an opportunity to explain what we were to do and how we intended to do it. It also allowed us to listen directly to the views of our stakeholders. The networking sessions and posters provided the opportunity for those working in the NHS to share their own good practice with colleagues supporting clinical excellence.
  • As a result of the learning gained from the first work programme the Institute updated and circulated its interim guidance for manufacturers on preparing submissions for the Institute's technology assessment programme.
  • The public Board meeting was held in Manchester,  the Board confirmed that its preparation for YK2 was complete. The Board also approved 1) the membership and the Terms of Reference of the Remuneration and Terms of Service Committee. 2) Standards of Business Conduct for Institute Members and Staff 3) The Institute's Policy and Procedure for the Disclosure of Information in the Public Interest (Whistle blowing in the NHS) and 4) The Reservation of Powers to the Authority and Delegation of Powers
  • Following a series of meetings with the NHS R&D Health Technology Assessment teams the Institute published a summary document describing 'How the Institute Commissions its Technology Assessment Reports' .
  • Following the Guidelines workshop and a subsequent Partners' Council meeting the general principles underpinning the Institute's approach to guideline development were presented to the Board and approved.
  • In recognition of the importance of the web site in communicating with stakeholders and supporting the Institute's key aims for transparency the Institute tendered for a web project manager to handle its phase II web development. Mr Julian Fifield was appointed and began work on the Phase II web project with the Institute's Communications Director
  • The Appraisal Committee considered its first evaluation reports on hip prosthesis for primary hip replacement and the removal of wisdom teeth.
  • Press speculation regarding the review of the Taxanes began

January 2000

  • We began our review of the contracts with the effectiveness publications and the core clinical audit contracts it had inherited, in preparation for the new financial year.
  • The Board began consideration of the Institute's strategic plan.
  • Health economists Jo Lord and Alastair Fischer joined the technology appraisals team and Jo Topalian brought her knowledge of audit to the Institute, as Guidelines and Audit Co-ordinator.
  • The Appraisal Committee considered its evaluation reports on Taxanes for breast and ovarian cancer and for coronary stents in ischaemic heart disease.
  • The Institute was disappointed to learn of an apparent disclosure of its Provisional Appraisal Determination on hip prostheses to the media.

February 2000

  • The Institute entered consultation on the proposed process for Guidelines authoring. The paper was circulated widely and posted on the Institute's web site.
  • The public Board meeting was held in Plymouth.

Significant funding which had been transferred to the institute on its establishment supported the guidelines authoring for PRODIGY. The Board approved the proposal to review the process for authoring guidance in PRODIGY. The Terms of Reference for the review and the process and timetable were approved, subject to a change to 1.3 of the Terms of Reference to include all stakeholders. The Institute seconded Dr Anita Houghton from the Audit Commission to conduct the review.

The Institute has been given responsibility for significant funds associated with the promotion of effective clinical practice. The funding for the 4 Confidential enquires is part of this funding allocation. In January the Institute instructed Sir John Grimley Evans to conduct a review of the enquiries on its behalf and prepare proposals for the way forward. The Board approved the Terms of Reference, membership, process and timetable for the review of the Confidential Enquiries subject to the addition of a nurse as a member of the reference group.

The Board noted a report on the Welsh language Scheme, outlining the interim arrangements for the Institute to fulfil its obligations under the Welsh Language Act and future action plans, and the draft Business plan for 1999/2000 was discussed.

  • The Appraisal Committee considered its evaluation report on liquid based cytology and began its review of the Provisional Appraisal Determinations for hip prosthesis in primary care and wisdom teeth removal, in light of comments received during the consultation period.
  • Nancy Turnbull joined the Guidelines & Audit team as the Programme Manager.

March 2000

  • The Institute issued the results of its first full technology appraisal providing guidance to the NHS on the Removal of Wisdom Teeth. This guidance was recommended to all NHS dentists by the Chief Dental Officers for both England and Wales and is also being adopted by the private sector.
  • The Institute held a useful meeting with the Swedish Council on Technology Assessment in Health Care, an organisation involved in similar work to the Institute, in Sweden.
  • As part of the process of developing guidance on the use of hip prostheses for primary hip replacement an appeal was heard on the 31st March 2000.
  • We organised a seminar on our strategic approach to clinical audit, inviting over 70 participants from the NHS and academia. This raised as many issues at it helped us resolve, but it began the journey that has since led to the publication of our audit strategy.
  • The Appraisal Committee considered its evaluation report on proton pump inhibitors for dyspepsia and began its review of the Provisional Appraisal Determinations on Taxanes for breast and ovarian cancer and for coronary stents in ischaemic heart disease, in light of comments received during the consultation period.



In addition 1999/ 2000:

  • The Institute's accounts form Section two of this publication. The figure below provides an overview of the Institute's spend for the year.

1999-2000 Expenditure

  • The Institute developed and began its own Review of International Health Technology Assessment (HTA). The aim was to review nearly 100 international organisations conducting HTAs whose results impact on health care policy decisions. This work will complete mid 2000 and will be presented at the Institute's conference in November 2000.
  • The Institute holds its Board meetings in public and as a national organisation has decided to hold them in different parts of England and Wales. In the past year we have held meetings in London, Leeds, Cardiff, Plymouth, and Manchester.

At each meeting we have sought feedback from those attended and acted wherever possible to improve our meetings. To date we have attracted over 1000 people to our public meetings and at each meeting have an public question and answer session. The unconfirmed minutes, the Board papers and the feedback from each meeting are published on our web site.

  • The Institute has is committed to delivering on its responsibilities under the Welsh Language Act. From the outset we have produced dual language publications and the web site has Welsh language entry points and sections. During the past year the Institute has begun work on its Welsh Language scheme, the development of which is on time and to plan.
  • Throughout the year the Institute has spent considerable time in one to one meetings with all stakeholder groups. These include organisations that represent patients (we would draw attention to the developing relationship with the group Patients Involved in NICE, as being particularly important), individual health technology companies and the organisations that represent them. We also spent time with the other national bodies, NHS organisations, professionals and the bodies that represent them. We also spent time establishing relationships with International organisations involved in health technology assessment and clinical guidelines production throughout the world.
  • The Institute had an average of 3 articles published per month on its work and its progress in the UK. These were published electronically, in journals and in reference manuals for the NHS, Industry and patients. In addition the Institute supported the press and media in providing information they required on the Institute and how it works in an open and transparent manner.
  • Our end of year review would not be complete without a review of the Institute's speaking engagements. The Institute was committed to communicating face to face with as many stakeholders as possible during its first year. A review of our conference database shows that senior team members had presented at nearly 350 speaking engagements (graph below). These were a combination of local, national and international events. These engagements provided the opportunity for the Institute to explain its role in the NHS, how it was organised and the way it intended to work, to an estimated 35,000 people. They also provided the opportunity to test its policy in thinking and gain feedback from a two-way dialogue with key stakeholders.

Speaking Engagements 1999-2000

Selected Views from outside the Institute on our work to date.

" What NICE does is make tough decisions about priorities. We've got to set priorities. There's no argument about that. The only argument is about how you determine those priorities. We've got to take these decisions on the basis of the best scientific evidence, taking into account the clinical effect of the drug and whether it is cost effective".

Alan Milburn, Secretary of State for Health,

interviewed by Jon Craig Political Editor

Sunday Express June 25 2000.

"The NHS should not buy expensive medicines until their clinical effectiveness and cost-effectiveness have been evaluated by the National Institute for Clinical Excellence."

Royal College of Physicians Report April 2000

"I would like to take the opportunity to thank you for your help throughout the [technology appraisal] consultation process. It have been very much appreciated..."

Jane Bryan

Professional Relations Manager Reckitt&Coleman Products

"I would like to thank you and your staff for the courtesy shown to us during this [technology appraisal] process."

Paul Hooper

General Manager Eisai Limited

"May I take this opportunity to compliment NICE on the appraisal process undertaken with respect to coronary artery stents."

Chris Isherwood

General Manager Cordis UK

"I should like to congratulate your organisation on such a complete, easily understood and constructive proposal. It probably represents the best appraisal report on any medical device I have ever had the pleasure of reading"

Ken Cottam

Director of Commercial Services Division

Abbott Laboratories Limited

"Congratulations on your efforts to improve patient/user consultation."

Gail Sharp

Caring Services Director

Marie Curie Cancer Care

"I welcome this attempt to involve organisations like Headway in the production of Clinical Guidelines"

Kevin Curley

Chief Executive

Headway - National Head Injuries Association

"GIG [Genetic Interest Group] believes in the importance of taking the views of patients, carers and...the wider family into proper consideration when evaluating the impact of a particular clinical intervention. We welcome the commitment from NICE to including these views as a central strand of the Institute's decision making process"

Alastair Kent

Director, Genetic Interest Group

Sample Conference feedback.

"I wanted to say how much I enjoyed the conference and how impressed I was with the quality of the speakers and with the way you shared with us the progress you have made so far."

"I thought the conference overall was excellent and particularly enjoyed the 'Question time' type session with the staff of NICE"

"A short note to congratulate and thank you for such a successful and enjoyable conference last week. I am sure I am just adding to the many such messages you will have received!"

5. Looking to the Future

In the short term:

2000/2001 will be the first full year of operation for the Institute and, we will demonstrate that the systems we have put in place will deliver our work programmes.

The Institute's 2000/2001 Business plan provides the detail supporting our corporate objectives for the year, which are:

  • further develop our relationships with our stakeholders
  • define our roles in education, and in research and development
  • by the end of March 2001, we will:
  • deliver at least 26 sets of guidance based on our technology appraisals
  • review 13 clinical guidelines already in production, 'inherited' from the Department of Health and National Assembly for Wales
  • commission 10 new guidelines.
  • complete 7 guidelines.
  • And intend, following discussion with the Department of Health and the National Assembly for Wales, to complete a further set of referral
  • review 8 national audits and complete 5.
  • effectively communicate and disseminate our guidance to influence clinical practice.
  • further develop the Institute's strategic approach to its work
  • manage the organisation and its resources effectively.

Annual Conference - Clinical Excellence 2000.

In addition we are looking forward to the Institute's second Annual Conference. Where we hope to welcome delegates with an interest in Clinical Excellence from all sectors of the NHS, from the organisations that represent patients organisations and from the Health care industries.

The conference will be held in Harrogate on the 28, 29 and 30 November 2000.

In the longer term:

The Institute's Corporate Plan 2000/2003 (which will be reviewed in December 2000) describes the Institute's short and medium-term goals, as well as the broad strategy it has derived to meet them.

Further information can be found from: