How we made the decision

Approach taken

NICE is committed to keeping guidelines current. A check of the need to update a guideline (surveillance review) is undertaken by NICE on a regular basis. This seeks to identify recommendations that are no longer current or need to be revised. Given the number of published guidelines that make up NICE's guideline topics, the number of checks needed is considerable. To address this, adaptive processes and methods are used for checking that published guidelines are current.

We based the decision on surveillance 4 years after the publication of Patient experience in adult NHS services (2012) NICE guideline CG138. For this guideline, Cochrane reviews that were used to inform the recommendations during development were checked to determine whether they had undergone an update. The results presented in any updated Cochrane reviews were checked against the guideline recommendations to assess any potential impact. This evidence was considered alongside evidence identified for the 2014 Evidence Update on NICE guideline CG138. Furthermore, we checked the status of any legislation or policy documents that had been used to inform the guideline recommendations to determine whether these had been updated.

The above approach was taken due to nature of the guideline. This guideline is directed to generic patient experience in all settings and provides a framework that describes the key requirements for providing a high quality patient experience within the NHS. As a result, development of recommendations took into account:

  • Existing NICE recommendations related to patient experience

  • Selected systematic literature reviews for specific interventions that may improve patient experience

  • Guideline Committee consensus

A targeted call for evidence was carried out during consultation on the no update proposal to supplement the surveillance review and ensure that we capture the issues important to people affected by the guideline.

For full details of the process and update decisions that are available, see ensuring that published guidelines are current and accurate in 'Developing NICE guidelines: the manual'.

Previous surveillance update decisions for the guideline are on our website.

New evidence

This surveillance report provides an overview of 17 studies published since the end of the search period for the guideline (9 August 2013).

See appendix A: summary of new evidence from surveillance and references for all new evidence considered.

Views of topic experts

We considered the views of topic experts, including those who helped to develop the guideline and other correspondence we have received since the publication of the guideline.

Views of stakeholders

Stakeholders commented on the decision not to update the guideline. See appendix B for stakeholders' comments and our responses.

Two stakeholders provided comments during consultation and both disagreed with the decision not to update the guideline. Concerns were raised about:

  • Whether the guideline appropriately considers the Equality Act 2010 and the Health and Social Care Act 2012:

    • The guideline recommends that healthcare professionals should take into account the requirements of the Equality Act 2010 and make sure services are equally accessible to, and supportive of, all people using adult NHS services (1.1.6). The guideline also recommends that healthcare professionals should avoid making assumptions about the patient based on their appearance or other personal characteristics (1.1.5). Additionally, an equality impact assessment was carried out after development of the guideline recommendations. This document confirmed that the recommendations and quality statements have been formulated to promote equalities for all people who receive healthcare within the adult NHS services, irrespective of gender, ethnicity, disability, religion or beliefs, sexual orientation and gender identity or socio-economic status. No information was identified through this surveillance review to change those conclusions.

    • In terms of social care, the guideline discusses the importance of social care provision in patient experience, particularly around continuity of care. Additionally, NICE is currently developing a social care guideline on People's experience in adult social care services which is expected to publish in January 2018. This new guideline will complement NICE guideline CG138. The NICE Pathways will bring all relevant guidance together.

  • The guideline omitting children and young people:

    • Although the guideline specifically covers people who use adult NHS services, the guideline committee recognised that some people or groups may have had poor experiences of healthcare and need additional consideration in the delivery of high quality care (for example, because of their age, disability, race, religion or belief). Although the specific needs of such people or groups were not addressed within this guidance, the Guideline Committee considered the principles may be of use in local strategies to narrow inequalities in patient experience for children and young people.

See ensuring that published guidelines are current and accurate in 'Developing NICE guidelines: the manual' for more details on our consultation processes.

NICE Surveillance programme project team

Sarah Willett
Associate Director

Philip Alderson
Consultant Clinical Adviser

Emma McFarlane
Technical Adviser

The NICE project team would like to thank the topic experts who participated in the surveillance process.

ISBN: 978-1-4731-2007-5


This page was last updated: 11 August 2016