How NICE guidance is helping the NHS through financial uncertainty

With the current financial situation in the UK set to result in challenging times for the NHS, the role of NICE will become ever more important. As NHS service providers look to balance budgets, NICE guidance will continue to play its part through ensuring quality care for patients whilst making sure service providers are aware of how they can best spend their limited resources.

In fact NICE has been identifying aspects of clinical practice that PCTs can spend less on ever since it was set up 10 years ago - our guidance to the NHS contains around 150 such recommendations each year, across all our guidance programmes. There's no doubt that the NHS can become more efficient in the way clinical resources are used. Those savings will come from using treatments optimally, which includes using less of some of them in circumstances where little or no benefit is gained.

NICE is committed to working hard to support PCTs and NHS providers to make the best use of their money over the next few years, making the case both for investment and disinvestment through our guidance programmes.

NICE guidance - improving quality and saving money

As part of NICE's contribution to supporting the NHS in these new, challenging circumstances, we have published a list on our website of guidance, which, when implemented, will generate net cost savings. The list is based on costing work undertaken at the time of publication for all NICE clinical guidelines from January 2005 and technology appraisals from January 2006.

Over this period NICE guidance has resulted in a potential national estimated saving across the whole of the NHS of over £600 million.

Highlights

One of the notable highlights is the NICE clinical guideline on hypertension which was published in June 2006. The guideline provides a series of recommendations on the management and treatment of hypertension, including the use of a number of newer treatments for the condition. This includes recommendations on the use of ACE (or angiotensin-converting enzyme) inhibitors which work by lowering the patients' blood pressure levels, leading to a reduction in the risk of patients suffering an associated cardiovascular event, such as a heart attack or stroke.

The costing tool published alongside the guidance identifies that once fully implemented the NICE recommendations are estimated to generate a long term net saving of around £221 million. The potential savings identified are based on the use of these newer drugs at points in the care pathway where the guideline has identified them as being of the most benefit to patients.

The NICE technology appraisals programme has also identified which new treatments can save the NHS money. For example, once fully implemented the recent guidance recommending the use of alitretinoin for severe chronic eczema, should reduce the demand on dermatological services resulting in an annual estimated saving of just under £3 million across the NHS when compared to existing practice.

The range of support tools NICE develops to assist service providers with the guidance planning process also help service providers manage their costs. The tools illustrate the benefits successful implementation of the NICE guidance will bring, both in terms of improvements to patient care, and the long term financial impact to the service provider. For example the costing tool, which is developed for every NICE clinical guideline and technology appraisal, indicates the national estimated cost of implementing the NICE guidance, and allows NHS providers to tailor the costing tool to better reflect local circumstances, for example, in terms of the age, gender or ethnicity of the local population.

Andrew Dillon, NICE Chief Executive said: “The coming years are likely to present a set of unique challenges for the NHS which will bring NICE's role into sharper focus than ever before. It is therefore important that NICE continues to provide evidence-based recommendations that give service providers across the healthcare system clear guidance on the most effective use of NHS resources and the best means of further improving patient care. I hope the list now available on the NICE website is useful in providing a good understanding of the work NICE is carrying out in this area, ensuring that every penny spent by the NHS brings the maximum benefits to patients.”

Further information on NICE´s cost-saving guidance.

Issued: 15 October 2009