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Interview with Dr Nigel Beasley

Dr Nigel Beasley talks about his experience of being a Fellow at NICE and how he helped influence the uptake of NICE guidance.

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This podcast was added on 2 Nov 2012

Podcast transcript

Interview with Nigel Beasley, a Fellow at NICE

Would you mind introducing yourself, Nigel?

Nigel Beasley. I’m an ENT surgeon in Nottingham and I’m Deputy Medical Director of the Trust.

Q1: “And what’s your involvement with NICE at the moment?”

NB: “So I’m a NICE Fellow. I started in March 2011, so I’ve got another 18 months to run as a Fellow. And through my Fellowship I’ve become involved in various things at NICE including becoming an external reviewer for the NHS Evidence Accreditation process for organisations and looking at some of the QIPP programme work.”

Q2: “Earlier in the session for Fellows you mentioned the implementation of NICE guidance, and how there’s been a variation in terms of uptake. Could you expand on that please and expand on your experience of this?”

NB: “At a trust level one of my responsibilities is looking after the Clinical Effectiveness Committee and part of our remit is looking at how we respond to external best practice reviews, things like NICE guidance. And across the organisation – there are so many bits of guidance out there, clinical guidelines, technology appraisals, interventional procedures guidance – because there are so many bits of guidance we’ve had to develop a fairly rigorous system of process whereby each new piece of guidance is considered. We appoint a clinical lead. We look at how we are doing and we assess ourselves against the NICE guidance and how we are doing as an organisation. And then we see what we need to do to try and get ourselves compliant with that guidance as far as we can.

“It’s challenging, it requires a lot of work and therefore leads to some variation in our ability to implement each piece of guidance fully. And where it’s difficult to do things because it’s complex and we’re working across the whole healthcare community, and we’re involving people outside the healthcare community, we’ve had to be very careful to make sure that it doesn’t have adverse impact on our healthcare community or on ourselves as a trust. Because there’s often things that need investment and we have to prioritise.

“One of the things that we’ve done over the last couple of years is essentially risk assess our implementation plans. So if we’re not entirely compliant with NICE guidance where are we missing, how risky is that, how important is that for us? And where it is particularly important for us to implement that NICE guidance we will prioritise that area.”

Q3: “And what would be your advice to trusts who are starting this journey? What would you say would be the first steps to take?”

NB: “I think most trusts are probably quite well along the journey in fact because I think for many years the commissioners have been very keen to see that NICE guidance has been implemented across their organisations.

“My experience has been – have a very simple but very robust system and process whereby when NICE guidance comes into the organisation you have a very straightforward way that it’s fed out to an individual who can fairly rapidly review the NICE guidance and see how compliant the trust is against that guidance and then will have the necessary influence to be able to talk to their specialty or their directorate management team to be able to lever the changes that are going to be required to become compliant with NICE guidance. And also somebody who can sit down at a specialty meeting, or a directorate meeting and talk about the risks of non-compliance – somebody who has a fairly decent understanding of how it’s produced.

“So we have a network of people within the organisation to whom we send the guidance to get some assurance. But it’s time consuming, it’s challenging. But it’s the system and process. My job is really to make sure that that’s robust and in place.”

Q4: “And since carrying out this process have you noticed any implications in terms of resources? What have been the achievements of the outcomes and measures that you’ve seen?”

NB: “Implementing NICE guidance is essentially for the benefit of our patients. That’s why we do it. So you have to consider financial and time and other considerations – you have to look very carefully at that. But the bottom line is you are trying to improve the care, the quality of care, for your patients by implementing guidance that’s been produced through a very rigorous process by a group of experts with patients, with other healthcare professionals, who have all come together and agreed that this is the best way to deliver a particular healthcare intervention or the best way to deliver a health priority. And so as a trust we have assurance that it’s been done well. If we do it I think it benefits patients. I think our patients, the people who buy services from us, the commissioners, can have some assurance that we’re doing the very best we can as an organisation.

“So, yes, financial and other things are tricky and that’s why we have a prioritisation process and a risk assessment process, within the organisation to make sure that we’re treating things fairly and we’re prioritising where we need to.”

Q5: “And since becoming a Fellow what has your experience been of networking and have you found that useful at all?”

NB: “When I put my application form in one of the things I wrote on the application form was I’d like to be a NICE Fellow because I’ll get to meet all sorts of people who have all sorts of interesting ideas and have some influence over healthcare and healthcare policy. And it’s just a good opportunity to meet. And that’s other Fellows or people who work at NICE. And I am a ruthless networker and since starting as a NICE Fellow I’ve met all sorts of fascinating people who have got fascinating ideas and embed those with my own ideas about how things can take forward  – ideas that have come up from NICE or from other Fellows and try and stick it all together in some good ideas.

“So I think one of the great benefits of being a Fellow is that you get to meet all sorts of people who have done all sorts of fascinating things and you can share ideas and chat to them. And I think it helps you develop personally and I think it helps develop the ideas that you’ve got and look at how other people have done things. So ruthless networking has been a fantastic opportunity at NICE.”

Q6: “And to close, are there any general points that you would recommend to new Fellows who have joined the scheme on how they should go about influencing the uptake of NICE guidance?”

NB: “Firstly, we had an excellent induction where I was inducted into all the different types of NICE guidance that exist; because to be honest I didn’t know much about some of them. I completely confused clinical guidelines with interventional procedures guidance. I knew almost nothing about public health guidance. And so for me, as a new Fellow you need to really understand what NICE offers.

“The second thing I found really helpful was the methodology, understanding the methodology. How NICE produces its guidance. What is an ISA? How can NICE say that a new drug is not worth it? What is that all based on? And we had some excellent presentations on that. And I think once you’ve got a handle on what NICE produces and how they produce it, that would be the first thing as a Fellow that is really key. And that’s what we’ve done at induction.

“Once you know those things how do you go around influencing your organisation? You need to find out who are the key players in your organisation and your health community, who are the people who are responsible for looking after and implementing that guidance and really offering to help. It takes time, particularly in areas where you have a particular expertise. They will usually be very grateful for any assistance that you can give, particularly if you have an inside track on what’s going on at NICE. And potentially new developments are things that may not be widely known about. So for me the new thing that came online were NICE pathways. So it’s been part of my role to try and help people realise that they exist and point people in that direction.”

Dr Beasley, thank you very much.

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This page was last updated: 19 September 2012

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.