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A faulty production line

NICE multimorbidity guidelines ‘due next year’, announces NICE chief

Long-awaited guidance on the care of patients with multiple long-term conditions is set to be released next year, the head of NICE has revealed.

The new ‘multimorbidity’ guidelines have been in the pipeline for several years, but NICE expert advisors have admitted developing recommendations has been taking longer than expected because of difficulties extracting relevant advice from existing single-conditions guidelines.

Speaking today at the Pulse Live conference in London, NICE chair Professor David Haslam – a former GP – said the guidelines are now due out next year and that NICE ‘absolutely gets’ the difficulties GPs face trying to provide the best evidence-based care for their complex patients.

Professor Haslam said: ‘We absolutely get and understand the challenge of multimorbidity GPs face – after all there are more people with two or more conditions than there are with one long-term condition.

‘So our centre for clinical practice is currently working on guidelines for the assessment and management of multimorbidity, which will be coming out in 2016.’

Professor Haslam told Pulse the guidelines were provisionally slated for around September next year.

He said: ‘The guidelines will hopefully be published in September 2016 – which I know seems a long way off in the future, but it is an extraordinarily complicated area. Nonetheless, it is one which I see as critical for NICE to be able to help with because, fundamentally, every single GP and some secondary clinicians are already having to deal it with every day in the NHS.’

Professor Haslam said the guidelines will not attempt to cover the full range of multimorbidity, but to provide broad principles of patient-centred care with a particular emphasis on polypharmacy and how to stop unnecessary treatments.

He said: ‘It won’t be possible to take every single possible combination of conditions but it will include broad principles, particularly I hope focusing on the expectations of patients and what they want for their care, about managing multiple medications – the whole polypharmacy issue – and the evidence base for stopping treatments.’


Readers' comments (8)

  • It sounds as if the Nice Aspergers brigade are going to be challenged at last and a bit of real live medicine people with 10 different diagnoses all of which need medication where each pill is contraindicated because of the other pills needed. Let us hope it is the end of hospital appointments where the registrar says this is what you must have for your heart why did your GP Stop it ? , recent case AF on warfarin , fell , haematoma in thigh cost 2litres of blood when stopped warfarin was replaced by clexane !

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  • Yes 6.20 pm we seem to be getting a lot of very silly decisons from secondary care especially in the field of anticoagulation for af.No one seems to display any common sense any more,dont really expect NICE to either.It feels as though we are dissapearing into a litiginous black hole.

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  • Oh, goody goody. I can't wait. This is so exciting...

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  • 'it is an extraordinarily complicated area...'


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  • I'm not convinced we need NICE guidance for this. Why not encourage primary and secondary care clinicians to use their clinical judgement without fear of GMC or litigation. It should be made clear that guidance is there to help clinicians as a resource rather than something that should be adhered to at all costs. This should be clearly stated within each guideline issued by NICE. Ideally an open discussion with patients about pros and cons of treatments should be had taking into account their priorities, wishes, and preferences. If only we had the time to do this effectively and the resources to enable this e.g ready access to data on NNT/NNH

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  • Vinci Ho

    Absolutely get and understand GPs are to face is one thing, you have to be 'politically correct' to please your colleagues inside the tower( you do know which tower I am talking?) is another thing.
    My gut feeling is the final product of this multimorbudiry guidance is filled up rhetorics and jargons . Call me cynical ....But then who am I ? A powerless , ordinary , old GP.

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  • Quite frankly I trained as a Professional.

    Our jobs are being analysed in ever greater detail. Healthcare delivery is becoming analogous to forcing Professionally trained fine artists to fill in numbered areas with paint. We are having all clinical autonomy taken away from us

    The thought processes by the powers are that ultimately computers will be able to perform our job.

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  • This group of complex patients is exactly the kind of area where guidelines are less useful because every case is different.

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