Process and methods

6 Teams involved in developing interventional procedures guidance

6.1 The interventional procedures programme team

The interventional procedures programme is part of NICE's Centre for Health Technology Evaluation. The programme team consists of the Associate Director and technical, project management and administrative staff. The team supports the Committee and is responsible for carrying out aspects of the work associated with developing guidance. This includes:

  • compiling information about procedures notified to the programme and deciding whether they are within the programme's remit

  • preparing evidence summaries and commentary for consideration by the Committee

  • arranging public consultation on the Committee's draft recommendations

  • preparing guidance for publication by NICE

  • ensuring NICE's published processes and methods for the development of interventional procedures guidance are followed in line with agreed timelines and standards of quality.

The programme team is committed to improving its practice and methods by conducting operational research and audit.

Other teams at NICE also provide support to the development of interventional procedures guidance.

6.2 The guidance information services team

The NICE guidance information services team searches for evidence relevant to the procedures. This evidence is used by the programme team to prepare an overview of each procedure for the Committee.

6.3 The publishing team

The NICE publishing team reviews and edits the documents that support the development of interventional procedures guidance for publication on NICE's website. These include evidence overviews, consultation documents and guidance. The team also produces the lay version of the guidance: 'information for the public'.

6.4 The adoption and impact team

The NICE adoption and impact team produces audit tools for procedures when the Committee's recommendations state they are needed, and when there is no suitable register or organised system for data collection. The audit tools are developed with advice from specialist advisers and Committee members, as appropriate.

6.5 The public involvement programme

In relation to the development of interventional procedures guidance, NICE's public involvement programme:

  • facilitates recruitment of the Committee's lay members and supports them during their term of office

  • identifies patient commentators and obtains commentary from them on the procedures being assessed (see section 6.8)

  • establishes links with patient organisations with an interest in interventional procedures guidance

  • encourages members of the public and patient organisations to respond to consultation.

NICE uses the terms 'patient organisation' and 'patient group' to include patient, carer, service user, community, voluntary sector and other lay organisations, including those that represent the interests of people from groups protected by equalities legislation.

6.6 The Interventional Procedures Advisory Committee

The Committee is made up of 25 members who are independent of NICE. It includes:

  • clinicians who carry out interventional procedures

  • 2 lay members who are familiar with the issues affecting patients and carers

  • experts in regulation and in the evaluation of healthcare

  • a Chief Executive of an NHS trust

  • a Medical Director of an NHS trust

  • a GP

  • a nurse

  • a representative from the medical device industry

  • a member with special knowledge of patient safety issues.

The Committee meets monthly (except in August) in public. Agendas and minutes of Committee meetings are published on NICE's website. The minutes are a contemporaneous note of the business of the meeting.

Committee members are required to submit an annual declaration of interests and declare any conflicts of interest at each Committee meeting, in line with NICE's policy on conflicts of interest.

The terms of reference and standing orders for the Committee can be found on NICE's website.

The role of the Committee

The Committee makes recommendations to NICE on the efficacy and safety of interventional procedures and on the context of guidance, such as the conditions under which procedures should be used.

How Committee members and the Committee Chair are appointed

Committee members and the Chair of the Committee are recruited through an open advertisement posted on NICE's website. They are appointed for a period of 3 years using the process described in NICE's policy and procedure on committee recruitment. A member's term of office may be extended for a further 3 years by mutual agreement, and up to a maximum of 10 years. A list of current members is on NICE's website.

NICE is committed to the values of equality and diversity, and welcomes applications for membership of the Committee from all sections of the community.

6.7 Specialist advisers

The programme team and the Committee are assisted by specialist advisers, who are clinicians involved in the use of identified interventional procedures or in the care pathway for the condition. NICE seeks the opinion of at least 2 specialist advisers on a procedure before it is considered by the committee. These specialist advisers are nominated or ratified by their professional organisations. NICE uses the term professional organisations to include royal colleges, and professional societies and associations.

The role of specialist advisers

The specialist advisers provide advice about interventional procedures that complements findings from published research. In addition, specialist advisers may be asked (within their area of expertise or knowledge) to advise the programme team and the Committee on related matters to enable NICE to produce the guidance and supporting materials. Specialist advisers are not expected to do a literature search. This is made clear on the questionnaire sent to specialist advisers. The advice may encompass:

  • the validity of the notification and its relevance to the programme's remit

  • the content of the brief

  • the content of the overview

  • the outcomes to be included in an audit tool for the procedure when this is recommended in the guidance

  • issues relating to the collection of further data in registers or other datasets

  • the content of a lay version of the guidance: 'information for the public'.

They may be called on to provide their opinions to the Committee in person when necessary, for example, when there is no Committee member present from the relevant specialty. Specialist advisers are asked to declare any conflicts of interest on a detailed pro forma (see section 10.1).

How specialist advisers are identified

NICE identifies specialist advisers in 2 ways:

  • NICE approaches a professional body to nominate individuals able to give an informed opinion about interventional procedures. NICE anticipates that, in nominating specialist advisers, professional organisations will have due regard to the Equality Act 2010.

  • A current specialist adviser or a Committee member recommends another clinician to give specialist advice. Then, the relevant professional body is asked to ratify the clinician as a specialist adviser.

To minimise bias, NICE seeks specialist advisers who have and have not done the procedure. Sometimes, for very new procedures, it may not be possible to gain advice from a specialist adviser who has done the procedure.

Occasionally, and normally only if NICE cannot obtain specialist advisers by these means, the programme may approach medical device companies to ask if they know any specialists involved in using or researching the procedure. NICE seeks ratification by their professional body of specialist advisers identified in this way.

Appointment duration

Approved specialist advisers are appointed to the programme for a term of 3 years, and are given the option to renew their term every 3 years. A specialist's eligibility to advise the programme ends if they retire from NHS practice or are subject to disciplinary or legal proceedings arising from their work.

A list of specialist advisers ratified by their professional body is published on NICE's website.

6.8 Patient commentators

The Committee draws on information supplied by patient commentators who have either had the procedure or are the carer of someone who has.

The role of patient commentators

The process by which patient commentary is obtained is designed to produce information on patients' experience of the procedure. It is separate from, but complemented by, the information and views from patient organisations and individual patients through the usual NICE consultation process (see section 13).

Patient commentators complete a questionnaire about their personal experience of the procedure, which is considered by the Committee when it develops draft recommendations on a procedure.

How patient commentators are identified

NICE approaches the notifier of a procedure to find out where the procedure is being done, and if possible the names of the clinicians doing it. This may be in the NHS or in private practice. NICE then contacts the identified clinicians to seek agreement for patients or their carers to be invited to complete a questionnaire on their experience of the procedure. If the total number of patients who have had a procedure is fewer than about 50, NICE asks the identified clinicians carrying out the procedure to send the questionnaire to all patients. If the figure is more than about 50, to keep administration manageable, NICE asks the clinicians to send questionnaires only to a sample of patients. The clinicians send their patients the questionnaires on NICE's behalf because of data protection legislation.