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    12 Support for putting the guideline recommendations into practice

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    12 Support for putting the guideline recommendations into practice

    12.1 Introduction

    The NICE strategy for 2021 to 2026 outlined the importance for our guidance to provide useful and useable advice and for it to purposefully influence the health and care system to adopt the best possible care. We have agreed 4 strategic aims for implementation:

    • embedding implementation upstream

    • strengthening external collaboration and partnerships

    • developing implementation campaigns for health and care system priorities

    • increasing data use to measure uptake and impact of NICE guidance.

    Implementation is considered from the guideline monitoring and scoping stages and throughout the guideline development process for topics aligned with system priorities.

    NICE teams work with committees, partner organisations and stakeholders from all relevant sectors to identify potential challenges for implementation and to consider what can be done to address these. For some topics, resources may be developed to support implementation and they will be linked to from the guidance. For other topics, there may be a need to embed recommendations within policy documents or to raise guidance awareness with key stakeholders and so support teams in NICE will work to do this. The rest of this chapter outlines some of the resources and initiatives available to support NICE guidance implementation.

    12.2 Tools for planning and resource impact assessment

    NICE provides a baseline assessment tool for each guideline at the time of publication. Organisations can use the tool to identify whether they are in line with practice recommended by NICE, and to help them plan and record activity to implement the guideline recommendations.

    We have developed a resource planner to help users plan for and implement our guidance by listing forthcoming guidance, and summarising the resource impact of in-development and published guidance.

    NICE resource impact assessment tools can help organisations assess the potential costs, savings and capacity impacts associated with implementing the guideline. For guidelines that will have a significant resource impact, a resource impact report and resource impact template are produced, where data allows. A guideline's resource impact is significant if the national cost is more than £1 million per year for a single recommendation or £5 million per year for the whole guideline. The template enables a local estimate to be made of the potential costs, savings and capacity impacts involved in guideline implementation. When costs and savings cannot be quantified, but the resource impact may be significant, a resource impact summary report is produced. If the guideline's resource impact is not significant, a 1-page resource impact statement is produced.

    12.3 Into practice resources

    Visual summaries and quick guides

    For some guidelines, there is a need for a visual summary of part of the guideline for health or care practitioners. For example, where practice needs to change, a practitioner needs to make quick decisions, or a specific audience needs support in implementing the recommendations.

    For some social care topics, a quick guide is produced to help practitioners with putting recommendations into practice (for example, in a care home), or to support people using services to understand what to expect and make decisions about their care.

    Decision aids

    If a guideline contains a highly preference-sensitive decision point, we may develop a decision aid.

    Decision aids support shared decision making by the person and their health or care practitioner. They provide information on the care or treatment options and help people to think about, clarify and communicate the value of each option to them personally. Decision aids do not advise people to choose one option over another, nor are they meant to replace the discussion with the health or care practitioner. Instead, they support people to make informed, values-based decisions with their health or care practitioner.

    Into practice guide

    Our into practice guide shows how evidence can be used to improve care and services. It sets out the most common steps taken when putting evidence-based guidance into practice.

    12.4 Measuring the use of NICE guidance

    Our quality standard service improvement template, helps providers make an initial assessment of their service compared with a selection of quality statements.

    The innovation scorecard reports on the use of medicines and medical technologies in the NHS in England that have been positively appraised by NICE.

    A range of data is used to measure NICE guidance. Examples include NHS England's Secure Data Environment (SDE), other national data collections, clinical audit, and data from journals. Insights from people affected by our guidance are also valued to fill gaps in data.

    12.5 Working with other organisations

    Organisations from all sectors and individuals, both lay and practitioner, can play a key role in supporting guidance implementation and we may work with external partners to help with this. NICE is working to strengthen external collaboration so that we can maximise opportunities for implementation, for example, by aligning with partner's regulation, monitoring and improvement frameworks.

    Other organisations may produce resources to support guideline implementation and NICE may work with them to ensure that the guidance is correctly referenced and embedded within the resource.

    NICE prioritises implementation campaigns to reflect the priorities and needs of the health and care system.

    12.6 Other NICE implementation support

    The following services and resources help to put all NICE guidance and standards into practice:

    • The implementation and adoption team work with guidance development teams and national partners to support implementation. The team also collects information from the health and care system to feed into NICE to help ensure we deliver useful and useable guidance.

    • Members of the field team support regional and local health and care systems to implement NICE guidance and use quality standards. The team also provides feedback and intelligence to NICE on the views of stakeholders.

    • The medicines optimisation team supports the implementation of NICE products and provides feedback and intelligence to NICE from the NHS and other stakeholders, with a specific focus on medicines optimisation. It does this through national, regional and local networks, especially the NICE medicines and prescribing associates.

    • The impact team measures the impact of NICE guidance to support guideline development, target implementation, and improve outcomes within health and social care.

    • An implementation strategy group comprised of external academics provides expertise and feedback on NICE's implementation activities and keeps the organisation up to date on new and ongoing developments in implementation science.

    • The public involvement programme team works with national and local voluntary and community sector organisations and members of the public to promote the use of our guidance and standards, and support implementation.

    We also seek feedback from people who use our guidelines to help make guidelines and implementation resources as easy to use as possible. We welcome system intelligence and information about any of our guidelines and use this to inform our monitoring and topic intelligence work. This enables us to prioritise our guideline updates and implementation support work.