We've identified NICE guidance that could generate cost savings.
In some cases, implementing guidance will free up resources and capacity that can be used for other services. This results in improved productivity rather than delivering actual cash savings.
Our resource impact reports and templates (linked in the table below) allow you to more accurately estimate savings for your local setting.
Find out more
|Guidance||Why does this guidance save money?||How will the guidance save money?||Estimated saving per 100,000 population (£)||Estimated saving for England (£ million)|
Savings are anticipated as a result of a shift in diagnostic imaging.
An increase in the number of people receiving CT coronary angiography leads to savings from reduced numbers of people receiving invasive coronary angiography and other diagnostic tests.
|Ciclosporin for treating dry eye disease that has not improved despite treatment with artificial tears (TA369)||
The resource impact assessment indicates that there will be a saving from implementing the guidance due to decreased drug costs and the large eligible population. Savings will be less in earlier years due to lower initial uptake of the technology.
|Faecal calprotectin diagnostic tests to differentiate inflammatory bowel disease from irritable bowel syndrome (DG11)||It is anticipated that there will be a cost saving from avoiding referrals to secondary care. This should lead to a reduction in capacity requirements and waiting times for endoscopy/colonoscopy/sigmoidoscopy in secondary care services.||£20,000||£11.1m|
|Virtual chromoendoscopy to assess colorectal polyps during colonoscopy (DG28)||Resource impact work indicates implementation will be cost saving from the avoidance of unnecessary histopathology assessments when assessing colorectal polyps.||
|Spectra Optia for automated red blood cell exchange in patients with sickle cell disease (MTG28)||Savings for commissioners are expected due to the reduced number of people requiring chelation therapy.||£18,100||£12.9|
|HeartFlow FFRCT for estimating fractional flow reserve from coronary CT angiography (MTG32)||
There may be a significant national saving from the avoidance of unnecessary invasive coronary angiography (ICA) and percutaneous coronary interventions (PCI). The availability of 64-slice CT coronary angiography may be a barrier to realising the savings in full.
There is currently no national tariff for HeartFlow FFRCT and uncertainties around funding flows for provider organisations may be a barrier to implementation of the technology.
Commissioners are encouraged to work with provider organisations to develop a local tariff to establish the use of HeartFlow FFRCT in interventional cardiology service provision.
|Menopause: diagnosis and management (NG23)||
The recommendations should result in a decrease in the number of follicle-stimulating hormone tests being received by women aged 45 years or older and because of this a saving of £9.6 million for England is expected.
Some additional costs may result if women change from using oral to transdermal hormone replacement therapy. These costs are estimated as £0.9 million, resulting in an overall saving of around £8.7 million for England.
|Thopaz+ portable digital system for managing chest drains (MTG37)||
Guidance has been published which recommends that Thopaz+ should be considered for people who need chest drainage after pulmonary resection or because of a pneumothorax. The resource impact is anticipated to apply to provider organisations only. Savings are mainly from a reduced length of stay in hospital.
|XprEss multi sinus dilation system for treating chronic sinusitis (MTG30)||
There may be savings from reduced inpatient procedures, fewer revision operations being needed, and fewer readmissions following treatment with XprESS. The level of savings depends on how many XprESS procedures are done in an outpatient setting and the device cost of XprESS.
Additional benefits include reducing the number of inpatient bed days needed, and increasing day-case and operating theatre capacity.
There is currently no national tariff for providing XprESS in an outpatient setting. Commissioners are encouraged to work with provider organisations to develop a local tariff.
|PIGF-based testing to help diagnose suspected pre-eclampsia (DG23)||
Implementation of the guideline may lead to a reduction in bed days and increase available clinical time. Current estimates indicate that national savings of around £7.3 million may be possible in year 5. The savings are not anticipated to be cash releasing.
|Bladder cancer: diagnosis and management (NG2)||
Savings are expected to arise from a reduction in the number of people with low risk non-muscle-invasive bladder cancer receiving follow-up cystoscopies in secondary care after 12 months.
|Macular degeneration (wet age-related) - aflibercept (1st line) [ID519] (TA294)||
Aflibercept is associated with fewer treatment and monitoring visits: implementing this guidance is therefore likely to release resources to the NHS. Fewer visits will also reduce the burden on people with wet AMD and their carers in terms of time off work and travel costs.
|SecurAcath for securing percutaneous catheters (MTG34)||
Resource impact work indicates implementation will be cost saving by avoiding or reducing the need to replace adhesive securement devices for PICCs, and are greater the longer a PICC is in place.
|Adjunctive colposcopy technologies for examination of the uterine cervix - DySIS and Niris Imaging System (DG4)||
Use of Dysis may reduce the number of repeat tests and follow up appointments due to higher sensitivity than conventional colposcopy.
It is anticipated there may be fewer diagnostic biopsies required, giving pathology test savings, however the improved sensitivity may lead to an increase in treatment biopsies.
Future years savings may be achieved through avoiding progression to surgical interventions. Use of Dysis will incur capital costs with some on-going maintenance costs.
|Hypothermia: prevention and management in adults having surgery (CG65)||
Implementing the guideline may result in the following benefits and savings:
|EXOGEN ultrasound bone healing system for long bone fractures with non-union or delayed healing (MTG12)||The expected annual savings and resources released from using EXOGEN 4000+ per 100,000 population aged 18 years and over is around £5,700. This arises from reduced need for surgical intervention and the associated hospital resource use.||£5,700||£2.9m|
|Vision Amniotic Leak Detector (ALD) to eliminate amniotic fluid leakage as a cause of vaginal wetness in pregnancy (MTG15)||
Using the Vision ALD could potentially save between £15 and £24 per women depending on the clinical scenario used. This is mainly a productivity saving resulting from reduced staff time required for administering Vision ALD compared to a speculum test.
|GreenLight XPS for treating benign prostatic hyperplasia (MTG29)||
Savings range from £1.3 million when 36% of procedures with GreenLight XPS are done as day cases, to as much as £3.2 million when 70% are done as day cases. Based on 53% of GreenLight XPS procedures being done as day cases, the guidance is estimated to save the NHS around £2.3 million per year.
|High-throughput non-invasive prenatal testing for fetal RHD genotype (DG25)||
Resource impact work indicates there may be some savings from offsetting the test cost with avoided unnecessary treatment with anti-D immunoglobulin.
Additional benefits include conserving anti-D immunoglobulin stocks and reducing potential adverse events that can be associated with blood product use. Implementation of the guidance will result in savings to providers.
|Quantitative faecal immunochemical tests to guide referral for colorectal cancer in primary care (DG30)||
Faecal immunochemical tests are recommended for routine adoption in primary care to guide referral for suspected colorectal cancer in people who have symptoms but are at low risk. The guidance may lead to savings at a local level from a reduction in the number of colonoscopies performed.
|Assess locally||Assess locally|
|Urinary tract infection in under 16s diagnosis and management (CG54)||The recommendations on urine testing strategies for infants and children over 3 months and under 3 years have been updated. The savings are dependent on local practice. The estimated annual saving of implementing this guideline for England is anticipated to range from £870,000 to £7.8 million per year.||Assess locally||Assess locally|
|ENDURALIFE powered CRT-D devices for treating heart failure (MTG33)||
ENDURALIFE-powered CRT-D devices are expected to be cost saving because they have a long battery life. This means that fewer replacement devices are needed, which reduces exposing patients to an unnecessarily higher risk of complications associated with these replacement procedures.
|Assess locally||Assess locally|
|Antimicrobial stewardship: changing risk-related behaviours in the general population (NG63)||Implementation of the guideline is anticipated to be cost saving with a reduction in the inappropriate prescribing of antimicrobials, an increase in the most appropriate use of antimicrobials, a corresponding reduction in the prevalence of antimicrobial resistance and reduced infections.||Assess locally||Assess locally|
|Physical health of people in prison (NG57)||
Implementing the recommendation on medicines reconciliation may generate savings for commissioners by reducing costs related to non-elective attendances and prison escort and bed watching. There may need to be some reallocation of resources within prison healthcare to implement this recommendation.
There are a number of recommendations in the guideline where it may be necessary to invest resources to support early interventions and planned management of conditions for people in prison. This investment may lead to savings from reducing emergency incidents and admissions, unplanned treatments, late presentation of conditions, and morbidity and mortality from infectious and communicable diseases.
|Assess locally||Assess locally|
|The MAGEC system for spinal lengthening in children with scoliosis (MTG18)||The insertion costs of MAGEC rods are estimated to be £27,400, with an annual lengthening cost of £900. In contrast, conventional growth rods are estimated to cost £15,300 for insertion and £5,400 for annual lengthening. The additional insertion cost of £12,100 for the MAGEC system has a payback period of less than 3 years. Anticipated savings per child after 6 years are estimated to be around £12,000.||Assess locally||Assess locally|
|Asthma: diagnosis, monitoring and chronic asthma management (NG80)||The guideline is likely to be cost saving. This may require service redesign to deliver the diagnosis recommendations and changes to medicines prescribing for the management recommendations in order to achieve these savings.||Assess locally||Assess locally|
|Glaucoma: diagnosis and management (NG81)||Due to variation in population and practice, resource impact should be assessed locally. The updated guideline may result in some savings if generic prostglandin analogues are prescribed. There may be significant savings from treating ocular hypertension with generic prostaglandin analogue, and from raising the intraocular pressure treatment threshold to 24mmHg or above. There may be offsetting costs to community optometry from increased testing and monitoring.||Assess locally||Assess locally|
|The Debrisoft monofilament debridement pad for use in acute or chronic wounds (MTG17)||The savings are either productivity savings where a district nurse undertakes other duties from the time freed up from the use of Debrisoft, or cash releasing where staffing numbers are reduced, or a combination of both types of saving.||Assess locally||Assess locally|
|The geko device for reducing the risk of venous thromboembolism (MTG19)||This technology is anticipated to be cost saving, with the cost impact predominantly affecting provider organisations. The additional costs from use of the device in secondary care are expected to be offset by savings from decreased rates of venous thromboembolism. The savings will be from a reduction in the length of stay in hospital and conditions associated with venous thromboembolism.||Assess locally||Assess locally|
|Atrial fibrillation and heart valve disease: self‑monitoring coagulation status using point‑of‑care coagulometers (the CoaguChek XS system and the INRatio2 PT/INR monitor) (DG14)||Has the potential to lead to cost savings for Clinical Commissioning Groups (CCGs) and NHS England through self-monitoring of coagulation status and improved management of long-term vitamin K antagonist therapy and associated adverse events for people with atrial fibrillation and heart disease.||Assess locally||Assess locally|
|Myocardial infarction (acute): Early rule out using high-sensitivity troponin tests (Elecsys Troponin T high-sensitive, ARCHITECT STAT High Sensitive Troponin-I and AccuTnI+3 assays) (DG15)||Implementation of this guidance should lead to more effective use of NHS resources. This is because people may be discharged from hospital after a shorter period of time, meaning hospital beds are not occupied inappropriately waiting for test results.||Assess locally||Assess locally|
|The TURis system for transurethral resection of the prostate (MTG23)||Using the assumptions in the External Assessment Centre’s additional economic analysis for hospitals already using monopolar TURP systems a saving of £71 per patient and an additional cost of £20 per patient for other hospitals is estimated. If savings from reductions in readmissions is included, the TURis system results in an estimated saving of £375 per patient for hospitals already using Olympus monopolar systems and an estimated saving of £285 per patient for other hospitals.||Assess locally||Assess locally|