Process and methods
18 Links with other NICE guidance-producing programmes
18.1 How the interventional procedures programme works with other guidance-producing programmes at NICE
Sometimes a procedure that appears to be within the remit of the interventional procedures programme is notified to the topic selection process at another part of NICE. If this occurs, the relevant topic selection team forwards the notification to the interventional procedures programme for consideration. In particular, the medical technology evaluation programme is designed to engage with medical technology and diagnostic companies to identify innovative products with potential benefits for patients and the healthcare system. Some of these products may feature in novel interventional procedures, and the programme teams liaise to ensure that procedures fitting the programme's remit in which these products are used are assessed by the interventional procedures programme.
NICE guidelines place established treatments in the care pathway, and it is therefore generally only appropriate for them to include interventional procedures when a recommendation has been made for use with standard arrangements and there is a degree of clinical interest in the procedure.
If the scoping group for a guideline decides that a procedure for which interventional procedures guidance recommends standard arrangements is relevant to its clinical guideline but will not justify a review question, the interventional procedures guidance is referred to in the 'related NICE guidance' section of the guideline.
If the scoping group for a guideline considers that a procedure published under standard arrangements is likely to justify a review question, the procedure's clinical and cost effectiveness is assessed using the NICE guideline programme's normal assessment methods and processes (see chapter 8 of the guideline manual).
If the guideline committee opinion is that a procedure with a recommendation for use with special arrangements has become part of mainstream practice and it is appropriate to assess it as part of the NICE guideline, the committee formally notifies the procedure to the interventional procedures programme to allow for potential update of its guidance. If, on reassessment, the procedure changes to a recommendation for use with standard arrangements, its clinical and cost effectiveness can be assessed as part of the guidelines process. If, after reassessment by the Committee, the procedure retains its special arrangements recommendation, the NICE guideline will refer to the procedure as 'related NICE guidance'.
Sometimes, when the Committee deems the evidence base insufficient to make a recommendation for use even with special arrangements, the guidance recommends that the procedure should be carried out only in research. Where there is evidence of no efficacy or the procedure is judged to be unsafe, the guidance recommends that the procedure should not be used. As such, they would not normally form part of a review question in a NICE guideline.
If a clinical guideline is already in development when a relevant notification is received, the interventional procedures programme will pass the finalised scope(s) for the relevant procedure(s) to the CCP at NICE. If interventional procedures guidance in development has not been finalised at the time of the clinical guideline consultation, the consultation document is referred to in the 'Related NICE guidance' section of the guideline.
When a newly notified procedure has been scoped and it has been agreed that it will be assessed by the interventional procedures programme, and a clinical guideline is already being developed in this area, the procedure will not form part of the clinical guideline (see chapter 8 of the guideline manual).
It is usually appropriate for the efficacy and safety of procedures to be considered before either the medical technologies or technology appraisals programmes address the value of the devices used in the procedure, or the procedure itself. Among the procedures considered by the interventional procedures programme to be safe and efficacious enough for routine use, there will be a small number that may be suitable for such an evaluation. This is likely to involve, for example, devices that are indicated for a common health problem or where the costs to the healthcare system of introducing the device are very different from those of existing treatments. In these circumstances, the procedure is passed to NICE's Medical Technologies Evaluation Programme to consider the appropriateness of developing further NICE guidance.