NICE process and methods

1 The NICE Indicator Programme

1 The NICE Indicator Programme

1.1 What is a NICE indicator?

NICE indicators generally measure outcomes that reflect the quality of care or processes linked by evidence to improved outcomes. Outcomes are ideally, but not always, related to NICE quality standards. Process indicators are evidence- based and underpinned by NICE quality standards, NICE guidance or other sources of high-quality evidence.

NICE indicators differ from quality measures within NICE quality standards because the measures used in quality standards are not formally tested and are often intended to be adapted for use at a local level.

The term 'NICE indicator' is used in this guide to describe outputs of this formal process.

1.2 Components of a NICE indicator

A NICE indicator is made up of the following:

  • a denominator, describing the target population included in an indicator

  • a numerator, describing the number of people in the denominator who have the specified intervention, treatment or outcome

  • a description of the inclusions, exclusions and exceptions.

Other elements of a NICE indicator may be:

  • a short and long indicator title

  • a detailed overview of the indicator, which includes:

    • a description of the purpose of the indicator

    • the reasoning for the indicator

    • data source, reporting mechanisms and other technical details

    • links to further information

  • a cost-effectiveness and resource–impact analysis.

1.3 How NICE indicators can be used

NICE indicators are published in a 'menu' on NICE's website. NICE indicators may be used in a number of different settings to support high-quality care. This may include:

  • measuring the quality of care and outcomes for defined populations

  • setting priorities for quality improvement

  • supporting the development of local performance dashboards

  • benchmarking performance against national data

  • demonstrating progress that local systems are making on improving outcomes (for example, in the Public Health Outcomes Framework)

  • supporting national performance schemes (for example, the Quality and Outcomes Framework [QOF] and the Clinical Commissioning Group Outcome Indicator Set [CCG OIS])

  • informing commissioning decisions.

1.4 Key principles and activities of the NICE indicator programme

The NICE indicator programme operates according to the NICE core principles. These include using:

  • a comprehensive evidence base (as described by NICE quality standards, NICE guidance or other sources of high-quality evidence)

  • an independent advisory committee

  • input from experts, patients, service users and carers

  • transparent processes and decision-making

  • public consultation

  • effective dissemination and implementation

  • regular review.

The key activities of the NICE indicator programme are to:

  • produce indicators as part of a menu of indicators that measure the delivery of safe, effective and cost-effective care and services

  • identify how indicators can be used to improve outcomes, including quality of life and satisfaction with care and experience

  • give stakeholders and respondents (including the public) an opportunity to contribute through an inclusive, open and transparent consultation process

  • consider the resource impact of indicators

  • consider the equality impact of indicators

  • consider the sustainability of indicators

  • regularly review and update indicators

  • align with other national quality initiatives.

  • ensure indicators are held within the National Indicator Library, hosted by NHS Digital.