NICE and the NHS

NICE's role was set out in the 2004 white paper ´Choosing health: making healthier choices easier´. In it the government set out key principles for helping people make healthier and more informed choices about their health. The government wants NICE to bring together knowledge and guidance on ways of promoting good health and treating ill health.

Where NICE guidance applies

Where NICE guidance applies differs for each type of guidance:

Applying NICE guidance

Once NICE guidance is published, health professionals (and the organisations who employ them) are expected to take it fully into account when deciding what treatments to give people.

However, NICE guidance does not replace the knowledge and skills of individual health professionals who treat patients; it is still up to them to make decisions about a particular patient in consultation with the patient and/or their guardian or carer when appropriate.

What health professionals are expected to do depends on the type of NICE guidance:

NICE supports effective public health practice

NICE public health guidance is not only used by people in the NHS. The audience for this guidance includes people working in:

• local government
• education
• public utilities (such as gas and water companies)
• private sector
• voluntary sector
• central government developing public and social policy

Our guidance helps all these people make decisions that are based on evidence.

NICE supports effective clinical practice

NICE and the National Service Frameworks (produced by the Department of Health) set clear national standards for NHS services and treatments. In 2004 the Department of Health published a document, ´Standards for better health´, which sets out how NHS organisations should respond to NICE guidance.

Medicines and devices

NICE does not license drugs or devices. Licensing drugs and devices in the UK is done by the Medicines and Healthcare products Regulatory Agency (MHRA). It makes sure that medicines, healthcare products and medical equipment are safe and do what they are supposed to do.

Most licensed drugs and devices are assessed at a local level within the NHS, to decide whether local hospitals, GPs and health organisations will prescribe them. NICE is asked to look at particular drugs and devices when there is confusion or uncertainty over the value of a drug or device or when prescribing practices vary across the country - so that patients may be receiving different prescribed treatments, depending on where they happen to live, rather than on the state of their health.

While a drug or device is being appraised by NICE, NHS organisations should make decisions on its use locally, using their usual arrangements. A recommendation by NICE ends any uncertainty and inequality about prescribing. Once national guidance has been issued by NICE, it replaces local recommendations and promotes equal access for patients across the country.

NICE and the Health Development Agency

NICE was preceded by the National Institute for Clinical Excellence, which was set up in 1999 and also known as NICE. The functions of another NHS organisation, the Health Development Agency (HDA), were transferred to NICE on 1 April 2005. Read more about the HDA.

Further information