We expect you to take our guidance into account, but people also have the right to be involved in discussions and make informed decisions about their care, as described in your care.

Using recommendations

Recommendations are based on:

  • the trade-off between the benefits and harms of an intervention
  • the quality of the underpinning evidence.

Some recommendations are made with more certainty than others. We word our recommendations to reflect this. For example we use 'offer' to reflect a strong recommendation, usually where there is clear evidence of benefit. We use 'consider' to reflect a recommendation for which the evidence of benefit is less certain.

Developing NICE guidelines: the manual has detailed information on this.

Shared decision making

We are working with other leading health organisations to encourage discussions between the people receiving and delivering care.

Find out more

Prescribing medicines

You should use a medicine's summary of product characteristics when making decisions with patients.

Sometimes a medicine doesn’t have a UK marketing authorisation for a particular condition but we still recommend it. We only do this when there is good evidence for it. If we do recommend this ‘off-label’ use, we'll say so in our recommendation.

You should follow relevant professional guidance and take full responsibility for the decision.

For more information, see:

Professional guidelines, standards and laws


The Government has produced statutory guidance that must be followed in both adult safeguarding and the safeguarding of children and young people.

When using this guidance, remember that abuse and neglect:

  • is common
  • may co-exist with health problems or social care needs
  • can present anywhere, including in emergency departments and primary care.

Consider or suspect abuse as a contributory factor or cause of an injury in adults at risk.

For more information, see all of our guidance and quality standards on safeguarding.