The local face of NICE
The recent health White Paper expanded the role of NICE, with the Institute tasked with producing a series of quality standards outlining a vision of what high-quality care should look like on the NHS.
NICE will develop 150 of these quality standards over the next five years and will also move into social care, as well as continuing to produce public health guidance, clinical guidelines, technology appraisals, and give advice on medical technologies.
With so much going on - and set against the backdrop of an ever changing NHS - it's no real surprise that healthcare professionals, and those working in local government, sometimes struggle to keep up to date with all the work that NICE does and identifying how it fits in with their day-to-day roles.
But help is at hand in the form of NICE's team of implementation consultants. Set up in 2006, the seven-strong team provides a regional focus for implementation support and acts as the local face of NICE.
Each consultant focuses on a specific part of England to ensure that the team are able to respond to requests and visit organisations from as far flung as Cornwall to Newcastle and everywhere in between.
The team can offer updates and advice to help teams identify and successfully follow NICE guidance, help with problem solving by sharing examples of best practice from elsewhere within the NHS and local government, and offer staff the chance to air their views on the work that NICE is doing.
The implementation consultants review their approach every six months, to ensure that they are responsive to the needs that have been identified in the field, and that they achieve a fair and full coverage of all relevant organisations and networks. Most recently, they have embarked on a series of visits to Directors of Local Authority Children's Services across the country.
Jane Moore is the implementation consultant for London or more specifically anywhere within the M25, as she describes it.
A typical day for Jane sees her getting full value out of her Oyster underground pass as she travels across the Capital. Today, she has just visited a Foundation Trust in North London and is now down in Wimbledon to meet with staff at Sutton and Merton PCT.
The visit comes at a good time, as Janet Coninx, Head of Governance for the PCT, explains. “We are just about to embark on an audit of all NICE guidance within our PCT. We want to monitor our action plans and see how much of the guidance actually gets implemented.”
“NICE has a range of audit tools to help with this - and a base-line assessment tool that can be used to carry out an assessment across an organisation, pulling out the key recommendations,” advises Jane.
The topic of conversation moves on to the best ways to keep up-to-date with NICE guidance, either by using the online forward planner or by subscribing to the NICE e-newsletter, and to the development of quality standards.
“This is something that people are keen to discuss, given their prominence within the White Paper,” says Jane.
Ways to save money
Promoting initiatives to save money, particularly in an age of austerity cuts and with the NHS needing to make £4.35billion of savings, is currently a key message for the implementation consultants.
“Implementing NICE guidance can provide a way for PCTs to ensure that patients receive treatment that is proven to be both clinically and cost effective. It can also potentially free up resources and capacity that can then be channelled into other services.
“There is a whole section of the NICE website dedicated to cost saving initiatives and reducing inefficiency such as the database of “do not do” recommendations and the referral advice database, which can be easily accessed from our homepage,” says Jane.
NICE recommends that doctors encourage women to use long-acting reversible contraceptives (LARCs) instead of the pill - a change in clinical practice that can produce significant savings.
NICE has championed the use of LARCs since 2005 after figures showed that switching just 7 per cent of women from the pill to LARCs could save the NHS £100 million by reducing 73,000 unwanted pregnancies each year.
This is a piece of advice which fits in nicely with the work going on in Sutton and Merton. “We currently have a project on the use of LARCs in the area and are currently bidding for more funding so this guidance is useful,” she says.
Using high-quality evidence
The rest of the visit is taken up with a chat about NHS Evidence, often thought of as a different entity to NICE rather than being part of the Institute.
NHS Evidence is a free and easy-to-use internet-based service which provides access to quality-assured healthcare information including clinical guidelines, evidence summaries and drug information, explains Jane.
“It's an online search engine that allows everyone working in health and social care to access a wide range of information. It's like searching all of your favourites in one go. Then you can filter that information by clinical query, information source or look for drug or device information.
“It's really important to have a source of high-quality evidence, rather than relying on Google or Wikipedia.”
If you would like to meet your local NICE implementation consultant contact firstname.lastname@example.org
1 December 2010