11 Updating public health guidance

NICE guidance is published with the expectation that it will be reviewed and updated as necessary. NICE public health guidance is updated if new evidence emerges or if sections of the guidance are no longer relevant. NICE usually checks for evidence 3 years after publication, and then at 3-yearly intervals, to decide whether all or part of the guidance should be updated. If important new evidence is published at other times, NICE may decide to update the recommendations at that time.

Any decision to update public health guidance must be balanced against the need for stability, because frequent changes to published recommendations would make implementation difficult and might delay the production of new guidance on other public health issues.

11.1 Post-publication information

After the guidance is published NICE collects and collates information that might affect the timing and content of subsequent updates. This information may come from stakeholders, the review team, the Chairs and members of the Public Health Advisory Committee (PHAC). It may also come from an Evidence Update or similar product from another team at NICE. However, NICE does not actively seek new evidence on any published guidance before the scheduled 3-year review unless it is indicated in the guidance that important new information may emerge before the planned review date.

11.2 Exceptional update

If substantial new evidence becomes available within 3 years of guidance publication, the centre director, the associate director who led the project team and the lead analyst for the guidance review it. If there is sufficient evidence that 1 or more recommendations need updating in a way that will significantly change practice, a meeting with the Chairs and members of the PHAC may be arranged. Following these discussions the Guidance Executive decides whether an update is needed before the 3-year period has elapsed. If an exceptional update is necessary, the original scope is used and stakeholders are informed.

11.3 Review after 3 years

The need for, and extent of, any update is determined in the following stages.

  • The centre director convenes a meeting of a project team that will do an initial appraisal of the case for updating the guidance. The centre director and the project team consult a guidance update review panel to identify any changes in practice since the guidance was published and any additional evidence. The panel may consist of professionals, practitioners, technical experts and community representatives. The panel may include the Chairs and members of the PHAC that developed the guidance.

  • The project team, working with information specialists from the Evidence Resources Directorate, may carry out a rapid search and review of new published literature. The project team review any information that is available on the implementation and uptake of guidance recommendations, including post-publication queries and comments.

  • The centre director and project team assess the results of the findings and consults with stakeholders on its proposal as to whether the guidance requires:

    • an update

    • deferral of the planned update for a further 3¬†years

    • no further planned update

    • withdrawal.

  • The project team may amend its proposal, in light of feedback from stakeholder consultation and makes a recommendation to the Guidance Executive.

  • The Guidance Executive takes the final decision about updating the guidance.

  • The Centre for Public Health Excellence (CPHE) senior team allocate guidance to be updated to a PHAC according to the topic area and available resources.

11.4 3-yearly review

The review process is repeated at 3-yearly intervals for any guidance that was deferred at the 3-year review stage.

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