National Institiue for Health and Clinical Excellence

Annual Review - 2009/2010

Dr Monica Lakhanpaul on her NICE Fellowship

Citizens Council discussess incentives

Should people be given vouchers to encourage them to lose weight or give up smoking? That was the question put to NICE’s Citizens Council, a group of 30 ordinary people who bring the views of the public to NICE's decision-making.

At a meeting in May 2010, the Citizens Council was asked to consider whether there are circumstances when incentives could acceptably be used to help motivate people to live healthier lives. Almost two-thirds of the group concluded that incentives could be an effective way of encouraging people to change their unhealthy lifestyles providing that certain conditions are met.

Those who voted in favour of the use of incentives only did so providing that incentives should never be exchangeable for tobacco or alcohol and that they are only offered to people who are committed to changing their lifestyle.

Year two of the Fellows and Scholars programme

The Fellows and Scholars programme, another of the initiatives sent up by the Research and Development team, has gone from strength to strength in 2010/11 and is now in its second year with a new cohort of professionals.

The programme aims to foster a network of NHS health professionals committed to improving the quality of patient care within their local health and professional communities, as well as supporting the core values that underpin NICE's work.

The latest intake now includes a senior social care professional, following the publication of the government's Health and Social Care Bill and the announcement that NICE will expand its remit into social care.

Professor Peter Littlejohns, Director of Clinical and Public Health at NICE, explains: “This is a great opportunity for a social care professional to play a key role in supporting and advising NICE as it moves into social care.

“The fellow will be able to help us drive up the quality of care delivered and encourage the introduction of cost-effective innovation into practice. They will also be expected to act as a conduit of information or comment between NICE and frontline social care staff.”

How NICE is helping to cut costs

The NHS is facing perhaps the toughest financial climate it has ever had to encounter, with Sir David Nicholson, the Chief Executive of the NHS, warning that efficiency savings of £15-20 billion will need to be made over the next three years.

One of the ways in which the NHS can save money is to cut down on unnecessary treatments and procedures. To help with this, the Research and Development team created a “do not do” database.

The database contains recommendations on clinical practices that should be discontinued completely or should not be used routinely in the NHS, and contains recommendations that have been made since 2007, taken from NICE cancer service guidance, clinical guidelines, interventional procedures and technology appraisals guidance.

In October 2010, the team launched another cost saving initiative in the form of a referrals database to guide GPs when referring patients from primary to secondary care.

The NICE ‘referral advice' recommendations database covers referral advice for patients with the range of conditions NICE has published guidance on such as suspected cancer, lower back pain and psoriasis.

This database highlights recommendations from NICE guidance which clearly identify where patients might benefit from secondary care or specialist services and, by implication, those where patients would not benefit from these services.

As well as saving money, following the recommendations will also help to improve clinical outcomes and patient experience, as well as reduce local and regional inequalities in the care offered to patients.

The R&D team is also collaborating with the Cochrane Collaboration to identity “low value” interventions that the NHS should consider stopping.