Our recommendations are made by an independent advisory committee, which includes health professionals and people familiar with the issues affecting patients and carers.

Our recommendations

We make 4 types of recommendations in our interventional procedures guidance:

Use with standard arrangements for clinical governance, consent and audit

This is our most positive recommendation. It means that there is enough evidence for doctors to consider this procedure as an option.

Doctors don't have to offer this procedure to patients and should always discuss the available options with the patient before making a decision. You must also follow their hospital's policy about getting permission to perform operations and monitoring the results.

Use with special arrangements for clinical governance, consent and audit

This recommendation means there are uncertainties about the procedure is safe and effective. We also recommend special arrangements if there are known risks of serious harm that need to be carefully explained to the patient before they make a decision. It emphasises the need for informed consent, both from the patient (or carer) and from senior medical staff, such as the clinical governance lead in their trust.

Clinicians using the procedure should also collect data, for example by audit or research. If there is no method of data collection already available for a procedure, we publish an audit tool alongside the guidance.

Use only in research

This means that the procedure should only be carried out in the context of formal research studies, as approved by a research ethics committee.

We make this recommendation if the procedure is still considered to be experimental or because there are uncertainties that need to be resolved.

We make this recommendation if the evidence suggests that the procedure doesn’t work well, or if there are unacceptable safety risks.

Are our recommendations mandatory?

There is no legal requirement to comply with the recommendations we make, although it is considered best clinical practice for the NHS to do so. This means that if we have issued guidance recommending an interventional procedure, the NHS is not obliged to provide it.

Our guidance does not consider how much the procedures would cost the NHS, or whether the NHS should allocate funding for them. These decisions are made at a local NHS level and usually on a case-by-case basis.

Why do we publish this type of guidance?

Unlike medicines, there is no licensing system in the UK for operations or other interventional procedures. This means that it can be difficult for healthcare professionals to be fully informed about the possible risks and benefits of procedures that are emerging within UK clinical practice.

The guidance both encourages doctors to consider newer procedures that they may not have otherwise used, as well as protects patients by advising on the risks and benefits of their use.

Where do your recommendations apply? 

NICE was established in legislation as an England-only body. However, we have agreements with the devolved administrations so that Interventional Procedures guidance applies in Wales, Scotland and Northern Ireland.