1 Introduction

The National Institute for Health and Care Excellence (NICE) produces useful and usable guidance for the NHS and wider health and care system. We help practitioners and commissioners get the best care to patients, fast, while ensuring value for the taxpayer.

1.1 What is a NICE quality standard?

NICE quality standards set out priority areas for quality improvement in health, public health and social care. Each quality standard typically contains 5 quality statements with related measures.

NICE quality standards do not provide a comprehensive service specification. They define priority areas for quality improvement based on consideration of the topic area.

NICE quality standards apply in England and Wales (see the UK Government website and the Welsh Government website). Decisions on how they may apply in Scotland and Northern Ireland are made by the Scottish government and Northern Ireland Executive.

New topics can be referred to NICE by NHS England (NHSE) or the Department of Health and Social Care (DHSC).

1.2 Quality statements

Quality statements are clear, measurable and concise.

Each quality statement should specify 1 concept or requirement for high-quality care or service provision (for example, a single intervention, action or event). In exceptional circumstances a statement may contain 2 concepts or requirements if they are closely linked (for example, treatment that depends on the results of an assessment).

Each quality statement should also focus on the people using services and promote choice and involvement in decision-making. However, if the quality statement is addressing service delivery the responsible organisation may be the focus of the statement.

In addition, each statement is accompanied by:

a description of its implications for different audiences
reference to the underpinning evidence source
sources of data for measurement
definitions of the terms used
relevant equality and diversity considerations.

1.3 Quality measures

Quality measures accompany each quality statement. They address care or service processes and, if appropriate, care or service structures or outcomes.

Most measures are likely to be process measures because few outcome measures can be attributed to a single quality statement or used at local level to reliably assess the quality of care or service provision and allow comparisons between providers. If an outcome can be attributed to a single statement and used at a local level, it will be included as a quality measure.

Any timeframes for delivery of interventions or actions should be derived from the underpinning evidence source or expert advice received during development. Timeframes not derived from the underpinning evidence source should be noted at consultation on the draft quality standard or included as a result of consultation feedback.

Related national quality indicators or sources of routinely collected data, (such as national audits or other quality improvement projects) that could be used to measure the quality statement are also highlighted.

For statements where national quality indicators do not exist, the quality measures should form the basis for audit criteria developed by providers and commissioners for local use in assessing and improving the quality of care.

1.4 Underpinning evidence sources

NICE quality standards are underpinned by NICE guidance or, if NICE guidance is not available, other high-quality evidence-based sources such as guidance from Royal Colleges, international guideline developers and reports from national inquiries.

The acceptability of using externally developed evidence sources to underpin a NICE quality standard will be explored with stakeholders and is subject to approval by NICE's guidance executive.

The quality of guidance produced externally will be assessed using the AGREE II instrument. The quality of evidence sources not suitable for assessment using AGREE II will be assessed on a case-by-case basis.