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This paper aims to provide an overview of the recent National Institute for Health and Clinical Excellence (NICE) clinical guidance for diagnosis and treatment of adults with Autism Spectrum Disorder (ASD) and to discuss clinical and practical implications.

This is a summary and discussion of the NICE guidance for adults with autism. This includes discussion of relevant related guidance, the need for transition services for young people with ASD, education of professionals, applicability of the guidance to people with intellectual disabilities and challenges related to implementation of the guidance in a changing National Health Service.

The guidance provides an excellent overview of current and state-of-the-art strategies for diagnosis and treatment of ASD-related behaviours, and their level of evidence. In terms of diagnosis, the main recommendation for clinicians is to carry out a comprehensive assessment for adults with suspected autism, taking into account co-morbid mental health problems and potential unmet needs. In addition, NICE makes recommendations regarding pharmacological and psychological interventions and these are discussed. The guidance also makes specific recommendations regarding service design, for example the formation of Autism Strategy Groups. This will hopefully support the development of specialist adult autism services.

This paper provides new insights into the implications of the recently published NICE clinical guidance for autism in adults, relevant for health care professionals, service managers and service users.

The purpose of the paper is to provide healthcare organisations with an example of how the implementation of new interventional procedures and NICE guidance can be improved by adopting a synergistic approach.

The paper shows that following the introduction of the Interventional Procedure Programme (NICE) and the issue of Department of Health advice in 2003, it was considered that the hospital's process for implementing new interventional procedures should be revised and would be more effectively managed by integrating with the well established process for implementing NICE guidance. The strategy for implementing NICE guidance and the new interventional procedure ratification process at the Luton and Dunstable Hospital NHS Trust are outlined and describe individual and corporate roles and responsibilities that promote local ownership.

The paper provides information on how the Trust incorporated the national perspective into a local model, which ensures a well‐coordinated multidisciplinary approach to introducing innovative clinical practice safely.

This paper demonstrates a useful tool that may be adapted by other healthcare organisations and clinical governance professionals responsible for implementing new interventional procedures into local practice. The role of the Interventional Procedure Governance Committee in supporting the application, review, ratification and monitoring processes is explained.

The paper identifies a practical approach, ensuring that practice follows recommendations within guidance already published by NICE or are reported to the Interventional Procedure Programme if the procedure is not already included within the work programme.

This paper seeks to describe the public health guidance development activity of the new National Institute for Health and Clinical Excellence (NICE).

The paper outlines the origins of the public health guidance development work, the types of guidance in public health which NICE will produce, the methodological approach which will be used, the advisory body structure, the health economics which will inform judgements about cost‐effectiveness, the audiences for the guidance and the approach to health inequalities which will be taken.

The future recommendations which NICE will make in public health are signalled.

The paper provides a summary of the key processes which will be used in the production of public health guidance.

To date over 20 guidelines or technology appraisals have been issued. At first, it seemed implicit that these guidelines would be subject to the audit process and that NICE would provide guidance and practical support for undertaking this activity. NICE have now issued a template for the audit of NICE guidelines based on a multi‐level approach. While audit of NICE guidance is an essential element of the whole clinical governance agenda, the burden of work that this could introduce to Trusts may be unsustainable. Suggests possible alternatives to auditing NICE guidance and proposes the use of a minimum dataset and full exploitation of electronic means of data harvesting.

In 2014, National Institute for Health and Care Excellence (NICE) announced it was going to develop its first set of guidelines on learning disabilities. The topic was “behaviour that challenges” and in May 2015 NICE published a full set of guidance (371 pages) covering service user and carer experiences, assessment, risk factors and interventions for behaviour that challenges (NICE, 2015). The linked quality standards were published later in 2015. The paper aims to discuss these issues.

This paper explains the process of developing the guidance.

The final guidance is described in summary form, together with the quality standards.

This paper provides a brief summary of the NICE guidelines on people with learning disabilities and behaviour that challenges.

The purpose of this paper is to provide an overview of the organisational and procedural arrangements for priority setting in England and Wales. It describes the role of social values in the decision‐making process.

The processes and content of decisions made by the National Institute for Health and Clinical Excellence are analysed using the framework developed by Clark and Weale for identifying social values in health priority‐setting.

While countries are seeking to achieve similar outcomes from their health prioritisation processes, each country has established different systems that reflect the social and legal framework underpinning their health systems. England is somewhat unique in being explicit about assessing “value for money” and using formal cost‐effectiveness in developing policy.

Many countries are now considering the use of formal health economic methodologies to assess the value and prioritise health care interventions. However there is increasing recognition of the importance of values other than efficiency (cost effectiveness) in making acceptable decisions. This is manifest in the range of potential new approaches being developed including multiple criteria decision analysis.

Clinical guidelines from National Institute of Clinical Excellence (NICE) have been developed by a rigorous process using the highest‐level evidence base. Their objectives are to reduce the variations in clinical care and end the postcode lottery of healthcare delivery. They are backed strongly by the government's agenda, are expected to be implemented and to be monitored, and this is to be monitored by CHAI. Up until now, clinical guidelines have had a secondary status to expert witness testimony in determining the standard of care in law in medical litigation. However, guidelines from NICE may have a more influential role in determining the standard of care in law by setting the standard of expected clinical practice. Trusts need to be sensitive to this as part of their risk management strategy. Trusts should facilitate the implementation of guidelines from NICE and audit their use through the framework of clinical governance. In the rare event that a trust should decide to positively diverge from such guidelines, it should do so only through a mechanism of due process that is required in public law for the accountability of the reasonableness of such a decision.

Breakaway training is a mandatory training programme for mental health staff in both NHS and private services. However, the question that remains outstanding from the recent guidance on the management of short‐term violence published by the National Institute for Clinical Excellence (NICE) (NICE, 2005a; 2005b) is whether breakaway training is effective?This paper provides a history of and evidence for breakaway training, and a study examining the content of breakaway training in one English high secure hospital is provided.

This paper examines patient organisations’ participation in the technology appraisals process of the National Institute for Clinical Excellence (NICE). In particular, it considers two policy areas prominent in recent UK government health reforms – patient participation and evidence‐based medicine (EBM). Data have largely been obtained from unstructured interviews with patient/carer groups involved in NICE’s technology appraisals, patient/carer representatives from NICE’s committees, and NICE personnel, supplemented by observation of NICE’s Board and Partners’ Council meetings, and analysis of documentary evidence. The paper focuses on the nature of “evidence” in NICE’s appraisals process, in particular patient groups’ concerns about the relative “weights” attached to patient and scientific evidence. NICE has taken some steps to allay such concerns, but more clarity is needed about how evidence from disparate sources is handled, if patient groups are to feel that their submissions of evidence have had more than marginal impact.

Purpose – Although the US has lagged behind international developments in health technology assessment (HTA), renewed interest in HTA in the US has been fueled by the appropriation of $1.1 billion comparative effectiveness research (CER) in 2009 and the debate over health care reform.

Approach – To inform CER practices in the US, we present case studies of HTA from England/Wales and Germany: contrasting methods; relevance to the US; and impact on innovation.

Findings – The National Institute of Health and Clinical Excellence (NICE) was established in 1999 to inform trusts within the National Health Service of England and Wales. It uses cost-effectiveness analysis to guide the allocation resource across preventative and curative interventions. In Germany, the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) was established in 2004 to inform reimbursement and pricing policies for the statutory sickness funds set by the Gemeinsamer Bundesausschuss (G-BA). IQWiG evaluates competing technologies within specific therapeutic areas, placing more weight on clinical evidence and the relative efficiency of competing therapies.

Practical implications – Although having deep political and cultural antecedents, differences between NICE and IQWiG can be explained by perspective: the former guiding resource allocation across an entire system (macro-evaluation), the latter focusing on efficiency within the bounds of a particular therapeutic area (micro-evaluation). Given the decentralized nature of the US health care system, and the relative powers of different medical specialties, the IQWiG model presents a more suitable case study to guided CER efforts in the US.