NICE's new Fellows and Scholars programme
Professor David Barnett and Mr Barrie White discuss NICE's new Fellows and Scholars programme
This podcast was added on 18 Dec 2009
Interviewer:Welcome to this podcast from the National Institute for Health and Clinical Excellence.
In October 2009, NICE launched its new Fellows and Scholars programme, aimed at providing clinical and public health professionals further opportunities to engage with the Institute and work towards improving the quality of care within their local health communities.
The Institute is now encouraging outstanding professionals in the NHS in England to submit their applications for its first year.
In this podcast, the programme’s Senior Mentors, Professor David Barnett and Mr Barrie White will talk about their roles in supporting the Scholars and Fellows in their activities.
I‘ll begin by asking them how the programme came about, before moving on to which professional groups they are looking for and what they hope the programme will achieve, for NICE, the successful applicants, and for the NHS as a whole.
David and Barrie, welcome.
Q1 Interviewer: Could you give me some background information on how this programme came about and why is it important?
David:Well first of all I think the main catalyst of the programme was the Darzi report relating to High Quality of Care for All. In that report it was recognised that a lot of healthcare professionals already interact with NICE on its advisory committees and on various other aspects of its activity, including implementation of local practice, and it was recognised that these individuals gain a lot from being associated with NICE and even more importantly, NICE gains a lot from having healthcare professionals who disseminate the activities of NICE and implement the guidance it produces. So in order to try and enhance that activity, it was suggested that a further tranche of individuals should be encouraged to work with NICE and that’s how the fellowship and scholarship programme was developed or considered.
Q2 Interviewer: How will patients and the wider NHS benefit?
Barrie:Well I think NICE is arguably one of the most successful parts of the NHS reforms of the last two decades and continues to develop its range, breadth and depth of influence both in the UK and abroad, where it is widely mimicked as a modern healthcare model. Its outputs are evidence-based and clinically driven and although criticised occasionally, are widely respected and forms a cornerstone for much clinical practice and the basis of much regulatory inspection. Fellows and Scholars, by joining with this, will have an opportunity to meet with NICE and join with NICE and start to be able to take the NICE process back to their own hospitals where hopefully the patients and the wider health communities will be able to become more attuned with the way that NICE works and be able to develop things better for their local communities.
David:From the point of view of benefit to patients, it is widely accepted that patients want the best quality care which should be provided by the NHS. But in addition it is in the patient’s best interest that care is provided on the basis of value for money – first of all to ensure that the NHS can afford appropriate care for everybody within its remit, but most importantly, that the care that is provided and the approaches to treatments that are provided are the best available irrespective of cost, so clinical effectiveness is very important here in comparative effectiveness.
Q3 Interviewer: How did you both come to be involved in leading the programme?
Barrie:I’m a full time neurosurgeon. My contact with NICE goes back right to its early formation - at that time developing the programme for my own NHS trust and the local healthcare area. I’ve been part of NICE properly since 2003 – first as a member and then Vice Chair of the Interventional Procedures Advisory Committee. I’ve chaired two of their clinical guidelines and was involved with the implementation programme from its outset.
David:From my point of view I have been an NHS consultant with a specialist interest in cardiovascular disease for over 30 years but more importantly perhaps from the purposes of this programme, I’ve been involved with NICE for the last ten years having chaired the appraisals committees in various guises over that period of time. I’ve retired from the NHS and also from the appraisals team but I am grateful to have the opportunity to continue to work with NICE and encouraging the development of this programme.
Q4 Interviewer: What is the difference between the fellowships and the scholarships?
Barrie:Well the programme as a whole is designed to enable all healthcare workers including managers at all levels to join with this. They have in common the fact that they will create a fellowship in their own right so there will be a body of people able to to mix and learn from each other’s experience and expertise. The fellowships are rather more aimed at senior professionals for their experience in, and their understanding of, NICE and their delivery of NICE locally and nationally. The scholarships are rather more project-based and designed perhaps for people who are still in the training part of their career or in the early part of their senior career looking perhaps more at issues rather than the broader views.
Q5 Interviewer: What role will the appointed Fellows and Scholars play?
David:Well I think it follows on from the description that Barrie gave of the fellowships and scholarships, in that their role will be at one extreme to develop themselves personally in an understanding of the NICE processes and methods; for example, further understanding of the approaches to developing cost effectiveness, to implementing guidance, to look at innovative pathways of care. But also the other extreme will be that they will, by developing that interest in the interaction with NICE, will act as ambassadors and will be able to express what NICE does in their local communities or perhaps with specialist societies, or maybe in the colleges or in fora where managers meet to try and express the interest of NICE and to support its activities.
Q6 Interviewer: What sort of NHS professionals are you looking for?
Barrie:The programme is open to anybody currently working in the NHS. The main criteria will be the quality of the applications, how they link to high quality care and how they’ll link with the NICE programme or might influence NICE developments. We have been pleasantly surprised by the number of expressions of interest since the web pages opened. There have been thousands of people logging on to the site to look at thisand we’re expecting to be pleasantly surprised and challenged somewhat by the applications. There is lots of interest from clinicians already working in committees with NICE but at present we’re excluding those from appointment to either of these posts so that we can get new blood into NICE and hopefully foster relationships there outside of NICE.
David:I think it’s important to understand that this is a new programme and we are, if you like, testing the water. We will want to encourage expressions of interest from a wide range of professionals who are involved in delivering care for the NHS. That will include those particularly, for example, in management areas so we’re not just interested in clinicians who directly provide care but those who manage care, ensure it is implemented appropriately and have responsibility for, if you like, commissioning care so that will be people who work in PCTs as well as Trust boards, Trust Chief Executives – those sorts of individuals. In addition I think there will be a number of groups who provide care within the NHS that is not currently intensively covered by NICE activity – a couple of examples would be, dietetics and it may be that certain areas of complementary medicine which are now covered under NICE guidance, may be able to be accommodated for the scholarship or fellowship programme.
Q7 Interviewer: So what will successful applicants gain from the experience?
David:I think the applicants will gain from the experience in probably two different ways; first of all I think they will gain on the basis of personal development. There is little doubt that the activities of NICE with its international reputation provides perhaps arguably the most important way of understanding the clinical and cost effectiveness of new and emerging technologies and processes for delivering care and also the ways in which we have rigorously applied new principles of health economics, systematic reviewing and other scientific disciplines to developing that guidance. The Fellows and Scholars therefore will have an opportunity to develop their personal experience of that and use it in their own practices. The other way that they will I think gain is that there will be a kudos factor and we can’t we shouldn’t downgrade that. We are not looking for people that want to wear the fellowship and scholarship as some sort of badge of office but on the other hand they will benefit from that in our view on the basis that they will be working with an institution that has a worldwide reputation for the quality of what it does.
Q8 Interviewer: What will they do and how will it impact on their existing day-to-day roles?
Barrie:It differs depending on which part of the fellowship or scholarship programme they’re part of. It’s envisaged that the Fellows will give a day a month over a period of three years, although that’s flexible and it doesn’t mean that they have to be away from their trust particularly. The Scholars have rather a shorter term relationship – again it’s thought that this will be in the order of a day a week for a year’s period to complete a programme, a project of some kind or another.
David:I think the impact on their day to day roles will be that no longer can healthcare professionals ignore the future and that is that comparative effectiveness, cost effectiveness is part of healthcare management now across the world. NICE has catalysed this view and it has been taken up internationally that healthcare is an expensive business and has to be managed appropriately with the delivery of value for money. So the Fellows and Scholars by interaction with NICE, developing their own expertise in this area and their own understanding in this area will deliver that back to their local community and will begin to develop a greater corpus of individuals who understand this process – so there’s an educational role as well. They will become educators and they will educate others in the importance of this for healthcare management in the future.
Q9 Interviewer: So what about their employers – what will they gain from sponsoring their staff in this programme?
Barrie:NICE is increasingly part of the fabric of the NHS and a lot of the regulatory requirements that are built around the NHS are based on an assessment of how well organisations implement NICE. This relationship, this closer relationship with NICE, will unquestionably be valued by local trusts and I’m sure that people will be encouraged to join with NICE in order to give insights to the trusts as well as improve the healthcare delivery in those local trusts.
David:I think it is a two way street again and that is that there will be an output that is that the interaction with NICE will allow the Fellows and Scholars to feed back into their local environments as well as we’re hoping, particularly with some of the fellowships in a national sense, but also the reverse of that is that the local areas will be able to feed back their concerns, their misunderstandings and perhaps help NICE develop its processes for the future to more successfully apply its activities in local networks.
Q10 Interviewer: What stage is the programme currently at?
Barrie:The programme has been widely advertised and actively promoted to all parts of the NHS from PCTs through to trusts, the Department of Health and Royal Colleges. We’ve tried our best to engage all healthcare delivery systems and it’s apparent that there is considerable interest from exceptionally high quality applicants for these first posts, setting a benchmark for the future. The applications now close on December the 31st with the appointments of the first ten of each of the fellowships and scholarships to start at the beginning of April next year. There’ll then be an annual recruitment for the programme enlarging it steadily with time and experience to make sure it remains responsive to the needs of patients and the wider NHS.
David:I think this is the early part of the programme – we’re very excited about it. We think it has huge benefits to both the Fellows and Scholars, but also I think to the wider NHS and to NICE and what we’re hoping is that by attracting these individuals, they will begin to develop a network which will increase and enhance, and will become, as Barrie pointed out, a fellowship of those individuals who will be able, I think, to work together and to develop the whole programme in the future. I think it’s a very exciting programme, and both Barrie and I are very excited to be involved with it.
Interviewer:Professor David Barnett and Mr Barrie White, thank you very much for your time.
This resource should be used alongside the published guidance. The information does not supersede or replace the guidance itself.
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