National Institiue for Health and Clinical Excellence

Annual Review - 2009/2010

Dr Carl Parker, GP, discusses NICE guidelines

Recommending the highest standards of treatment and care

NICE’s clinical guidelines contain recommendations for the NHS on the best way of treating and caring for people with specific diseases and medical conditions.

During 2010/11 NICE published 25 new clinical guidelines, covering a wide range of health topics including anxiety, chronic obstructive pulmonary disease, and bed-wetting in children. In June 2010, NICE published its 100th clinical guideline since the programme began in 2002, on alcohol use disorders. By the end of March 2011, the number of NICE clinical guidelines published in total had risen to 121.

Over the course of the year NICE’s Centre for Clinical Practice has been integrating NICE’s work on quality standards and the Quality and Outcomes Framework with the clinical guidelines programme. In particular, as the number of NICE quality standards increases, as laid out in the Health and Social Care Bill, the Centre for Clinical Practice is working towards developing quality standards with the underpinning evidence base of a clinical guideline in parallel, so that a quality standard with its clinical guideline are published together.

In addition, during 2010/11 the Centre for Clinical Practice also made some changes to the way in which guidelines are reviewed in the years following their publication, in order to standardise the process across all guidelines. Now, each guideline will be reviewed three years after publication to decide whether new evidence means it needs to be updated.

Examples of clinical guidelines published this year

Food allergy in children and young people
Published in February 2011, this short clinical guideline focuses on diagnosing and treating children and young people with suspected food allergies, in primary care. The guideline also advises parents against use of alternative tests, such as Vega testing, hair analysis and kinesiology, which are widely available online. Instead, concerned parents should see their GP for either a skinprick test or a blood test for IgE antibodies.

Read more about the food allergy guideline

Chronic heart failure
In August 2010 NICE published a new guideline on diagnosing, treating, rehabilitating and monitoring people with chronic heart failure. Updating NICE’s original guidance on this topic published in 2003, the new guideline outlines best practice for healthcare professionals in both primary and secondary care, and includes recommendations on referrals, diagnostic tests and drug therapies, as well as exercise-based rehabilitation programmes.

Read more about the chronic heart failure guideline

Hypertension in pregnancy
In August 2010 NICE published a new guideline on the care and treatment of pregnant women who have, or who are at risk of developing, hypertension, which includes the condition pre-eclampsia. The recommendations include offering women at risk a low dose of aspirin daily during their pregnancy. Babies born to women who experience hypertension during pregnancy are also more likely to be premature, stillborn or smaller than average, while the mothers face an increased risk of developing high blood pressure later in life.

Read more about the hypertension in pregnancy guideline