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|
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.
|UrgoStart for treating diabetic foot ulcers and leg ulcers (MTG42)||There is uncertainty around the future uptake of UrgoStart dressings for people with diabetic foot ulcers. In the resource impact report we have modelled 3 scenarios of future uptake of 25%, 50% and 75% of the eligible population. We therefore estimate savings from treating diabetic foot ulcers with UrgoStart dressings to range from £5.5m to £19.1m for the population of England.||
|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.
|Chronic heart failure in adults: diagnosis and management (NG106)||
Implementing the guidance is likely to lead to savings from reduced readmissions to hospital for people with chronic heart failure. Investment in cardiac rehabilitation services may need to happen before potential savings can be achieved.
|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.
|Abortion care (NG140)||
The estimated financial impact of implementing this guideline for England in the next 5 years is a saving of around £660,000 in 2019/20 rising to a saving of around £6.6 million in 2023/24. Overall savings for both commissioners and providers are expected as a result of:
|Diverticular disease: diagnosis and management (NG147)||
The estimated financial impact of implementing this guideline for the population of England in the next 5 years is a saving of around £0.2 million in 2019/20 rising to a saving of around £5.3 million per annum from 2023/24. The savings result from:
|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.
|Hypothermia: prevention and management in adults having surgery (CG65)||
Implementing the guideline may result in the following benefits and savings:
|Renal and ureteric stones: assessment and management (NG118)||
The estimated financial impact of implementing this guideline for England in the next 5 years is a saving of around £853,000 in 2019/20 rising to a saving of over £2.8 million in 2022/23. The savings result from:
• an increase in medical expulsive therapy for stones less than 10 mm and a reduction in surgical interventions
|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.
|Thyroid disease: assessment and management (NG145)||
The estimated financial impact of implementing this guideline for the population of England in the next 5 years is a saving of around £0.1 million in 2019/20 rising to a saving of around £1.0 million per annum from 2023/24. The savings result from:
|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.
|iFuse for treating chronic sacroiliac joint pain (MTG39)||
We estimate that once people with a confirmed diagnosis of chronic sacroiliac joint pain whose pain is inadequately controlled by non-surgical management are treated, that around 50 people per year will be treated with iFuse. This will lead to overall savings from 2021/22 onwards.
|Assess locally||Assess locally|
|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|
|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|