NICE’s ‘one problem’ solutions are not enough
It’s not always clear what NICE does, writes Professor David Haslam, so I hope my experience as a GP will make its work more relevant to the profession
Does NICE really matter to GPs? In the busy world of everyday general practice, with too many patients and too little time, is NICE anything other than an optional extra? What does it do anyway, other than say which expensive drugs can, and cannot be used, by the NHS?
NICE is one of those organisations that most people have heard of, and yet few fully understand. From April, it is actually changing and becoming the National Institute for Health and Care Excellence, a subtle change that is much more than semantics. NICE’s responsibilities will also extend to social care, and every GP fully understands just how much health and social care overlap in the real world.
Its aim is to be the principal UK resource for evidence-based practice, commissioning and local decision-making in both health and social care, including practical support to help put its recommendations into practice. Its responsibilities include developing quality standards, clinical guidelines, NHS Evidence, the clinical domain of the QOF, the BNF, and a considerable international programme. Whether your work is primarily as a clinician, or is now beginning to focus more and more on commissioning, NICE could, should, and must be central to your work.
But I am very aware that there are challenges. Part of the reason that I am so delighted to bring my experience of general practice into my role as the next chair of NICE is that I absolutely recognise some of the concerns that GPs have with NICE.
A new challenge
Like so much else of the health and social care system, NICE has, in the past, had a tendency to focus on single conditions – indeed much of the NHS was designed on what seems like an assumption that people are healthy, get a single acute illness, have this treated, and return to normal.
As we know – this is far from the case. Long-term conditions – multiple long term conditions - are now the NHS’s core work, and this partly explains the centrality of primary care in the new system. NICE will be producing a guideline on managing co-morbidities, with GPs a key audience for this.
Having worked with NICE for several years, I think it is a remarkable and essential organisation. Moving forward, its new responsibilities in helping to drive up standards in social care through its guidance and quality standards will deliver the best possible outcomes for people. It’s going to be an interesting few years.
Professor David Haslam CBE is the chair designate of NICE, former BMA and RCGP president and former GP. He is also a national professional advisor to the CQC., and was number 16 in Pulse’s Top 50 GPs 2012.