Tools and resources

How NICE clinical guidelines are developed: an overview for stakeholders, the public and the NHS

Who is involved in developing NICE clinical guidelines?

Who is involved in developing NICE clinical guidelines?

Developing NICE standard clinical guidelines involves:

  • NICE

  • National Collaborating Centres (NCCs)

  • Guideline Development Groups (GDGs)

  • the Patient and Public Involvement Programme (PPIP) at NICE

  • expert reviewers

  • stakeholders.

The following sections explain the roles of these various groups.

NICE

When the Department of Health or the NHS Commissioning Board asks NICE to produce a clinical guideline on a particular topic, we commission one of the NCCs or the Internal Clinical Guidelines Programme to coordinate the guideline's development.

The guidelines team in the Centre for Clinical Practice at NICE supports and advises the NCC throughout the guideline's development. Each guideline has a Guidelines Commissioning Manager, as well as a Centre for Clinical Practice lead.

For guidelines developed 'in house', the NICE Internal Clinical Guidelines Programme within the Centre for Clinical Practice develops the guideline and carries out the tasks described for NCCs throughout this document.

NICE's 'Guidance Executive' is responsible for giving final approval of ('signing off') the guideline. The Guidance Executive confirms that the guideline has been developed in accordance with the remit, and by following the correct process and methods.

NICE publishes the NICE guideline, the NICE pathway and 'Information for the public', as well as the implementation support tools.

The National Collaborating Centres (NCCs)

The NCCs were established by NICE to develop clinical guidelines. The NCCs bring together the expertise of the medical and nursing royal colleges, NHS trusts, professional organisations, and patient and carer organisations. They have the capacity, skills and expertise to produce high-quality clinical guidelines, working closely with the GDGs.

Each NCC has staff with:

  • technical skills in:

    • guideline development

    • project management

    • health economics

    • reviewing evidence

    • using formal methods to reach consensus in areas where there is a lack of good-quality evidence

  • experience in engaging with patients and with patient and carer groups.

Each NCC also has access to professional networks to support its activities.

Role of the NCC

For each clinical guideline, the NCC:

  • prepares the draft scope and refines it in response to comments received during consultation

  • establishes and works with the GDG to develop the clinical guideline

  • undertakes systematic reviews of the literature and health economics analyses

  • ensures that the processes described in The guidelines manual are followed, and documents this

  • together with the GDG, prepares the consultation draft of the guideline

  • together with the GDG, makes changes to the guideline in response to comments received from stakeholders during consultation

  • publishes the final full clinical guideline

  • advises NICE on publishing, disseminating, implementing and updating the guideline.

There is more information about the NCCs on our website.

Internal Clinical Guidelines Programme

The Internal Clinical Guidelines Programme at NICE establishes and provides technical support to the GDGs for clinical guidelines that are produced internally ('in house').

Guideline Development Groups (GDGs)

One of the NCCs or the Internal Clinical Guidelines Programme sets up an independent GDG for each clinical guideline that is developed. GDG members include healthcare and other professionals, technical experts, and patients and carers who have relevant expertise and experience.

The role of the GDG in developing the clinical guideline is described below, and in chapter 3 of The guidelines manual.

The Patient and Public Involvement Programme (PPIP) at NICE

The PPIP is an integral part of NICE. Its main role is to work with our guidance-producing teams and the NCCs so that patients, carers and the public can be fully involved in developing our guidance.

The PPIP team also works with patient and carer organisations, and provides training and support for the individual patient and carer members of GDGs.

Advice and support to NICE

The PPIP team:

  • advises the clinical guidelines team at NICE on patient and carer issues

  • identifies and approaches potential patient and carer stakeholders for each clinical guideline topic

  • helps in recruiting patient and carer GDG members by promoting vacancies and encouraging applications

  • comments from a patient and carer perspective on the clinical guideline development process

  • for each guideline, comments from a patient and carer perspective on the draft scope and the draft recommendations.

Advice and support to the NCCs

The PPIP team:

  • advises on ways of involving patients and carers in the work of the NCCs and the GDGs

  • encourages and supports applications from patients and carers who want to get involved in the NCCs' activities, such as membership of GDGs

  • provides dedicated training for patients and carers who are actively involved in the NCCs' activities.

Advice and support to patients and carers

The PPIP team:

  • advises and supports patient and carer organisations, and individual patients and carers, who are interested in contributing to the development of NICE clinical guidelines

  • advises and supports people who apply to become patient and carer GDG members during the application and selection process

  • advises, supports and trains appointed patient and carer GDG members.

For information on involving patients and carers in clinical guideline development, see Kelson (2005)[1] and the G-I-N Public Toolkit: Patient and Public Involvement in Guidelines for guideline developers.

Factsheets on the NICE website explain in more detail how patients and carers, and the organisations that represent them, can get involved in developing our clinical guidelines.

Expert peer reviewers

The NCCs may occasionally commission expert peer reviewers to review part or all of a clinical guideline. This may take place during guideline development or during the consultation period for the draft guideline.

Stakeholders

Stakeholders play an integral part in the development of our clinical guidelines. This is described in detail in the section How stakeholders can get involved.


[1] Kelson M (2005) The NICE Patient Involvement Unit. Evidence-based Healthcare and Public Health 9: 304–307.


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