Implementing NICE guidance

Authors: Louise Crathorne, Lisa Cooper & Mark Pearson

The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to support the improvement of health and social care in England*

NICE guidance and advice sets priorities for investment of public funds through the identification of most clinically and cost effective treatments and services

NICE issues five types of guideline: clinical guidelines, public health guidelines, social care guidelines, safe staffing guidelines and medicines practice guidelines. In addition, it provides quality standards, technology appraisals and advice on highly specialised technologies, diagnostic services, medical technologies and interventional procedures

Evidence suggests that uptake of NICE guidance is variable. Only the implementation of technology appraisal guidance is mandatory for NHS organisations

Implementing NICE guidance requires change – influences of change may be categorised into three clusters: the innovation itself, the characteristics of the people involved and the context of its introduction

Guideline format and content are important aspects of implementation. Conceptual frameworks comprise the following elements: adaptability, usability, validity, applicability, communicability, accommodation, implementation and evaluation

Key elements to successful implementation of NICE guidance include: board support, clear leadership, a NICE manager, support from a multidisciplinary team, a systematic approach to implementation/financial planning and a process to evaluate uptake and feedback

NICE provides implementation tools, including a forward planner, costing templates, slide sets, audit support tools, commissioning guides, shared learning and implementation advice

The NICE uptake database can be used to find national audit data and external literature relating to NICE recommendations