NICE process and methods

7 The role of the CPHE project team

The Centre for Public Health Excellence (CPHE) is responsible for the development of public health guidance and for assuring the quality of the guidance so that it is up to date, credible, robust and relevant. The CPHE project team ensures that guidance is developed to the agreed timetable and in accordance with this manual and with Methods for the development of NICE public health guidance – third edition (2012).

Each member of the CPHE project team understands his or her personal responsibility for quality assurance through the application of these processes and methods.

7.1 CPHE project team

Centre director
The director of CPHE is responsible for all NICE public health guidance and for ensuring that it is produced in accordance with the published process and methods, including the appointment of Public Health Advisory Committee (PHAC) Chairs and members.

Associate director
Each associate director in CPHE is responsible for the development and quality assurance of specific sets of guidance, and has delegated responsibility for approving consultation and other documents. An associate director acts as the topic lead for each set of guidance, working with the CPHE team and the PHAC to provide topic and technical support to the Chair. The associate director also advises the Chair on matters of method and process.

CPHE senior team
The senior team is made up of the centre director and the associate directors. They meet regularly with the project managers to oversee the development of all public health guidance.

Lead analyst
The lead analyst is responsible for the technical quality assurance of the evidence reviews and the technical aspects of the guidance, working with the associate director and other members of the project team.

Technical adviser (health economics)
The technical adviser is responsible for ensuring the technical quality of the economic evidence and economic analysis, working with the health economics contractor and other members of the CPHE project team.

Analyst
One or more analysts work with the lead analyst to assure the technical quality of the evidence reviews and other technical aspects of the development of the guidance. If applicable, 1 or more analysts take responsibility for commissioning and coordinating the fieldwork.

Project manager
The project manager is responsible for planning the work of CPHE, scheduling, planning and timetabling the Centre's programme of work.

Support team
The coordinator and other members of the support team provide administrative support to the PHACs, arranging meetings, liaising with stakeholders and all individuals and organisations contributing to the development of public health guidance.

7.2 Topic selection briefing paper

Members of CPHE team prepare topic selection briefing papers for the Topic Advisory Workshops (TAWs) (see chapter 2), in collaboration with external experts and members of the NICE information services team.

Each topic briefing paper includes the epidemiological and policy importance of the topic in question, the extent of variation in practice and any relevant health equity and inequality issues.

Topic briefing papers do not specify referrals, nor do they specify whether guidance should be produced through the standard or fast-tracked process. The CPHE senior team decides this once the final topic referral has been made by the Department of Health (see chapter 2).

7.3 Facilitating stakeholder consultation

Potential stakeholders are identified and encouraged to contribute to the development of the guidance by the CPHE project team, working with the Patient and Public Involvement Programme (PPIP) (see chapter 9). For more details about the role of stakeholders and how to register as a stakeholder see chapter 4.

7.4 Appointing Chairs and members of the PHACs

The positions of PHAC Chairs are advertised on the NICE website. They may also be advertised in other appropriate places identified by the CPHE project team. The CPHE project team also informs stakeholder organisations about the advertisement.

The PHAC Chairs are appointed after interview by the selection panel, in accordance with NICE's policy on appointments to guidance-producing bodies advisory to NICE.

The CPHE project team informs registered stakeholder organisations about advertisements for core and topic expert members. PHAC core and topic expert members are appointed in line with NICE's policy.

PHAC co-opted members are selected by the associate director leading the development of the guidance, and agreed with the PHAC Chairs. Appointments are subject to confirmation by the CPHE director.

7.5 Preparing the scope

The CPHE project team prepares the scope for the guidance topic (see section 3.3). This work is conducted in the following stages:

  • Developing a preliminary search while working with NICE information services. This search is intended to identify other relevant guidance, such as previous clinical guidelines and key systematic reviews. This search should not aim to be exhaustive or to address potential review questions in any detail.

  • Drafting the scope in consultation with the PHAC Chairs, and PHAC core members (see chapter 3), as appropriate. For more information on scope development, including the use of 'logic' or conceptual models, see section 2.2.1 of Methods for the development of NICE public health guidance – third edition (2012).

  • Consulting with stakeholders on the draft scope. The CPHE project team may also arrange a public meeting for registered stakeholders during the 4-week consultation period.

  • Writing responses to all stakeholder comments on the draft scope. Responses are documented in a 'scope consultation table' which is published on the NICE website with the final scope.

  • Finalising the scope after consultation. The scope includes key questions that cover all aspects of the guidance remit, without going beyond it.

For more information about the role of stakeholders see chapter 4.

7.6 Assuring quality of evidence reviews and economic analysis

The CPHE project team commissions and manages the development of the evidence reviews and economic analyses produced by the evidence provider (contractor).

The CPHE associate director approves the review protocol, which has been developed by the review team, the CPHE project team, and information specialists in both organisations.

The CPHE project team discusses and agrees the organisation, presentation and interpretation of the evidence reviews with the review team.

The CPHE project team and the review team agree criteria for the inclusion of studies and how to identify relevant economic studies that are likely to inform the PHAC.

The CPHE project team works closely with the health economist from the review team and the PHAC to select interventions or questions for further economic analysis (including modelling) and to ensure that the economic modelling carried out by the review team is appropriate and plausible and results are accurately interpreted.

7.7 Supporting the PHACs

The CPHE project team plans and organises PHAC meetings, in consultation with the respective PHAC Chairs. The project team is responsible for setting the dates of the meetings, planning the agenda, sending out papers, keeping records of meetings, and (with the Chairs) signing off minutes to be posted on the NICE website.

The CPHE project team will hold an initial induction meeting for new co-opted PHAC members for each new topic, to familiarise them with NICE methods and processes. They may also be invited to observe a working PHAC meeting.

The first full PHAC meeting for a new guidance topic provides an introduction to the topic area, and discussion of planned evidence reviews for the PHAC Chairs and the members. At this meeting, the CPHE project team presents the scope, and the evidence provider presents plans for the evidence reviews and economic analysis. PHAC members discuss these plans and suggest appropriate amendments, and also identify areas or individuals for expert testimony.

7.8 Calling for additional evidence

If evidence is missing or is unclear, the CPHE project team may ask stakeholders for evidence. The project team specifies the question being addressed, along with details of the type of evidence being sought, and stakeholders are given 4 weeks to respond. This usually happens in the early stages of guidance development.

7.9 Compiling responses to consultation comments on the evidence and the draft guidance

Consultation with stakeholders on all the evidence reviews and on the draft guidance is an important part of the quality assurance process (see chapter 4). The CPHE project team addresses and responds to all stakeholder comments on the evidence and guidance with the support of the review team.

Each comment is acknowledged and answered as fully and as factually as possible. If changes are made to the guidance as a result of any comment, this is made clear in the response. If no changes have been made, the response from the project team explains why not.

The CPHE project team summarises and presents the comments and responses to the PHAC. All comments are taken into consideration in developing the final guidance.

Comments and responses are made available on the NICE website when the final guidance is published.

7.10 Drafting guidance

The CPHE project team drafts the guidance following PHAC discussion and direction, seeking approval for drafts and subsequent revisions. The CPHE project team ensures the draft recommendations are clearly linked to evidence.

From time to time, PHAC members may draft specific sections of the guidance, working with the CPHE project team. All amendments to the recommendations must be approved by the PHAC Chair.

When the draft and final versions of the guidance are prepared for publication, the CPHE project team ensures that any confidential information is replaced by a note stating that confidential information has been removed, so that the public is aware of exactly where confidential data have been used.

7.11 Managing fieldwork

Fieldwork may be commissioned by exception during the consultation process, when a PHAC is developing guidance in a novel or sensitive area. Fieldwork tests the feasibility of the draft recommendations with end users of the guidance (see chapter 8). The CPHE project team commissions a contractor to carry out the fieldwork on behalf of NICE. The fieldwork contractor should agree the plans, participants to be contacted, venues, methods and the content of all communications and supporting materials with the CPHE project team.

7.12 Advising on publication, dissemination and implementation

The project team submits the final draft of the guidance to NICE's Guidance Executive (see chapter 10) and makes any changes that may be required, advising the PHAC Chairs as appropriate.

The CPHE project team also works closely with the editors to ensure that the guidance and related NICE products, including the NICE Pathway, are unambiguous and appropriate for the intended audience.

The project team also works with the NICE communications lead to prepare for the launch of the guidance. This may include a press conference or a more targeted approach for specialist audiences.

The CPHE director and the project team work with the communications lead to contribute to communicating key messages about the guidance to the press and media and to promoting the guidance to wider public health audiences, and producing press articles at the time of, and after publication.

7.12.1 Implementation support tools

NICE's implementation team produces tools to support implementation of public health guidance (see section 1.5). The CPHE project team contributes to the development of these tools to ensure that they are accurate, and relevant to the guidance and to the target audiences.

7.12.2 Post-publication support

The CPHE project team may also support implementation in other ways including:

  • speaking at relevant conferences or events, and encouraging and supporting PHAC members to do so

  • contributing to or writing journal articles about the guidance

  • supporting workshops and regional events

  • working with field consultants (see section 1.5)

  • providing feedback and encouraging organisations to submit short reports about how they have implemented the guidance for the NICE shared learning database

  • supporting the development of educational support tools.

7.13 Updating guidance

After the guidance is published the CPHE project team collects and collates information that might affect any future updates from stakeholders, the review team, the Chairs and members of the PHAC. However the project team does not actively seek new evidence on any published guidance before the scheduled 3-year review, unless the original guidance indicates that an early review will be necessary (for example, when the PHAC know in advance that new evidence is due within the 3-year period).

When an update is considered, the CPHE project team consults experts and members of the relevant PHAC, as appropriate, to identify any changes in practice or additional relevant published evidence. The project team may then ask the information team to search for new evidence. In addition, the project team reviews any information that is available on the implementation and uptake of the guidance (see chapter 11).