| National
Institute for Clinical Excellence: initial work programme |
| Summary |
| This
HSC |
| i |
sets
out the proposed initial work programme for the National Institute
for Clinical Excellence (NICE) |
| ii |
explains
the basis on which NICE will carry out appraisals of existing
and new health interventions |
| iii |
asks
NHS bodies to continue with local arrangements for the managed
introduction of new technologies for any interventions which are
not referred to NICE, or where NICE's guidance is not available
at the time the technology first becomes available. |
| |
|
| Action |
| |
NHS
bodies are asked to bring the contents of this circular to the
attention of all clinical staff. |
| |
|
| The
overall context |
| 1 |
The
consultation papers A
first class service: quality in the new NHS (in England)
and Quality care and clinical excellence (in Wales) set
out the government's plans for a new National Institute for Clinical
Excellence (NICE) which would give guidance to the NHS in three
board areas: |
| |
|
| |
| i |
appraisals
of individual, new and existing, health interventions |
| ii |
Clinical
guidelines giving best practice advice for whole conditions
or patient groups; |
| iii |
clinical
audit methodologies. |
|
| |
|
| 2. |
Earlier
this year, the government issued a follow-up discussion paper
"Faster access
to modern treatment" with proposals on how NICE should
carry the first of these functions. In the light of the response
to this discussion paper, ministers in consultation with the National
Assembly for Wales have now agreed a "Memorandum
of Understanding" setting out the basis on which NICE will
operate; a copy is available on the Department of Health's website
(www.doh.gov.uk) |
| |
|
| 3. |
The
Department of Health, in consultation with the National Assembly
for Wales, has identified possible topics for referral to NICE
from two main sources: |
| |
|
| |
| i |
information
on new health interventions is gathered and prioritised
by the Horizon Scanning Centre at the University of Birmingham; |
| ii |
possible
topics for guidance on existing health interventions or
areas of clinical practice have been identified in the course
of work on National Service Frameworks, supplemented by
additional proposals from regional offices. |
|
| |
|
| 4. |
In
either case, possible topics are examined to determine whether
the more appropriate form of guidance would be an appraisal (of
an individual intervention), a clinical guidance or a clinical
audit methodology. Proposals are then considered in relation to
the Government's health priorities, to their intrinsic significance
to NHS patient services, and to the potential for NICE to "add
value". |
| |
|
| 5. |
If
a new intervention is not referred to NICE, this does not imply
any judgement on whether the intervention(s) in question are
clinically or cost effective. NHS bodies should continue to
use exiting arrangements to access the publicly available evidence
and to determine local policies for the managed entry of the
new intervention. The same principle should apply if an intervention
has been referred to NICE but guidance is not yet available
at the point which the new intervention is first introduced.
In the case of new pharmaceuticals, the New Drugs in Development
bulletin published by the National Prescribing Centre and Drug
Information Pharmacists Group may be a helpful source of information.
|
