This year NICE began issuing ‘recommendation reminders' from existing guidance to help the NHS make better use of its resources. The aim is to help the NHS reduce spending on ineffective treatments that do not improve patient care or represent good value for money.
To date, the Institute has issued 45 reminders relating to recommendations from nine clinical guidelines and four technology appraisals published between 2000 and 2005. They cover a range of topics from eating disorders and fertility to chronic obstructive pulmonary disease (COPD), multiple sclerosis, type 2 diabetes foot care and asthma in children.
Reminders are posted on the NICE website with a link to the relevant guidance. They come with an electronic tool to help local commissioners estimate the cost of implementation. They are also sent to relevant management and clinical communities in primary care trusts (PCTs) and other NHS trusts - mainly commissioners, but also healthcare professionals working with patients.
NICE works with the chair of the advisory group that developed the guidance and practising clinicians to select those recommendations that will have the most impact on reducing ineffectiveness. The focus is on those advising the NHS to restrict or stop use of a procedure, diagnostic test or approach.
One example is the routine use of spirometric reversibility testing in COPD as part of the diagnosis process and to help identify the most appropriate initial therapy for patients.
It is estimated that 1.5 million people in the UK are living with COPD. They need frequent support from primary and secondary care. Up to one in eight emergency hospital admissions may be due to the condition and GP consultation rates are at least twice as high as those for angina.
NICE guidance states that spirometric reversibility testing may be unhelpful and misleading (‘Management of chronic obstructive pulmonary disease in adults in primary and secondary care' NICE clinical guideline 12).
NICE has also released nine reminders about its fertility guidance (‘Fertility: assessment and treatment for people with fertility problems' NICE clinical guideline 11). The reminders cover recommendations about tests that are often used to investigate fertility problems.
For example, NICE has advised against offering a thyroid function test to women with fertility problems unless they have symptoms of thyroid disease (because women with fertility problems are no more likely than the general population to have thyroid disease).
It has also stated that men who have white blood cells (leucocytes) in their semen should not be offered antibiotics unless an infection has been identified. (Leucocytes are present throughout the male reproductive tract and there is no evidence that giving men antibiotics will improve pregnancy rates.)
NICE plans to continue issuing up to four recommendation reminders every month in the year ahead.
The reminders are part of a set of three products that have been introduced by NICE as part of its ‘optimal practice review'. These also include: commissioning guides, which were launched in October 2006; and special technology appraisals and clinical guidelines that target areas where evidence suggests current practice is no longer effective.
More information on recommendation reminders is available on the NICE website at www.nice.org.uk/reminders.
This page was last updated: 24 June 2010