Our prioritisation decisions

We strive to ensure that our decisions are independent, consistent and transparent. To support this we've updated our prioritisation process, and now use a consistent, common framework to inform all our prioritisation decisions.

We're developing a new centralised approach to prioritising our guidance topics. This will ensure that we produce guidance that is relevant, timely, accessible, and has demonstrable impact.

Decisions will only be reviewed where there are factual errors or when significant new evidence comes to light following publication.

Stakeholders can seek clarification within 20 working days following the publication of the prioritisation board's decisions.

Prioritisation board decisions

2025

Prioritisation board meeting dateTopic titleDecisionRouting decisionRationaleDecision publication date
24 January 2025 Pain management in people receiving long term end of life care Not prioritised N/A Prioritisation Board noted that NICE has produced a range of guidance regarding pain management, some of which will be relevant to this population. It was agreed that NICE will not develop guidance in this area, but will explore whether a Clinical Knowledge Summary can be produced regarding pain management in non-cancer palliative care. 21 February 2024 
24 January 2025 Ketamine uropathy Not prioritised N/A Prioritisation Board noted that NICE has produced guidance regarding drug misuse prevention, and that there is a consensus statement from the British Association of Urological Surgeons on this topic. Consequently, they agreed that this topic should not be prioritised. 21 February 2024
24 January 2025 Plantar fibromatosis aka Ledderhose Not prioritised N/A Prioritisation Board agreed that there is very limited evidence available regarding this condition, and that there would not be value in producing a guideline. It was noted that there is an existing Clinical Knowledge Summary regarding Dupuytren’s disease and so it will be explored whether this could be expanded to also cover plantar fibromatosis. 21 February 2024
24 January 2025 GP identification and management of life-threatening emergencies Not prioritised N/A Prioritisation Board agreed that this topic is primarily related to training and professional development and that consequently NICE guidance on this topic would not be appropriate. 21 February 2024
24 January 2025 Tuberculosis Not prioritised N/A Prioritisation Board recognised that this is an important topic but that other agencies may be better placed to develop guidance on this topic. NICE will liaise with the UK Health Security Agency (UKHSA) to explore options as to how guidance should be developed on this topic. 21 February 2024
24 January 2025 Digital stethoscope for point-of-care detection of heart murmurs/arrhythmia Not prioritised N/A Prioritisation Board recognised that this is an important topic that will likely be of value to the system. However, they noted that there is an ongoing trial of this technology which is due to publish its results in December 2025. The topic will be reconsidered once those results have published. 21 February 2024
24 January 2025 Digital platforms for cardiac rehabilitation Prioritised HealthTech Prioritisation board agreed that digital platforms have the potential to address system needs in this area. 11 July 2024
26 February 2025 Machine perfusion devices for preservation of solid livers for transplant Prioritised HealthTech Prioritisation Board agreed that this looked to be a promising technology that addresses an unmet need in the system. Consequently, they agreed that the topic should be prioritised. 21 March 2025 
26 February 2025 Digital technologies to support people with severe mental illness in community settings Not prioritised N/A Prioritisation Board agreed that there is a lack of evidence in this area, and a lack of certainty regarding the potential benefits of any technology to allow NICE to develop guidance on this topic. It is an area that may benefit from additional research and NICE will liaise with system partners to explore this need for evidence generation. 21 March 2025
26 February 2025 Tics and Tourette’s syndrome Not prioritised N/A Prioritisation Board agreed this is a complex topic that overlaps considerably with other conditions. Many of the challenges relate to service provision, where NICE guidance is likely to have limited impact. It was, however, recognised that there could be value in developing a clinical knowledge summary on this topic, and NICE will explore this possibility further. 21 March 2025
26 February 2025 Blood transfusion (NG24) – tranexamic acid Prioritised Centre for Guidelines Prioritisation Board recognised that there is good quality evidence to support expanding the population who could receive tranexamic acid during surgery. There also appear to be potential resource savings for the NHS. 21 March 2025
26 March 2025 Tonsillectomy for recurrent tonsilitis in adults Not prioritised N/A Prioritisation Board recognised that there is existing guidance from the Academy of Medical Royal Colleges regarding tonsillectomy for recurrent tonsilitis. This guidance is aligned with advice for specialist assessment detailed in the clinical knowledge summary on sore throat. Consequently, they agreed that this topic should not be prioritised.
26 March 2025 Polihexanide eye drops for treating acanthamoeba keratitis in people 12 years and over (ID6497) Not prioritised as a highly specialised technology Technology appraisals Prioritisation Board agreed that criteria 1,3 and 4 of the highly specialised technology criteria were not met (see appendix 1 of NICE-wide topic prioritisation: the manual). Consequently, it was agreed that the treatment should be routed to the technology appraisals programme.
26 March 2025 Digital technologies that deliver CBT interventions for insomnia and insomnia symptoms (Disordered sleep) Prioritised HealthTech Prioritisation Board recognised that chronic insomnia impacts on a large population and that digital technologies have the potential to address the unmet need of in-person CBT provision. They recognised that a range of different digital technologies are available and agreed that there would be value in a multi-tech assessment of these products. Consequently, they agreed to prioritise this topic.
26 March 2025 Artificial Intelligence assisted Echocardiography to support diagnosis of heart failure Prioritised HealthTech Prioritisation Board recognised the potential system benefits of AI-enhanced echocardiogram in leading to improved accuracy of diagnosis and reduced waiting times. Consequently, they agreed this topic should be prioritised.
26 March 2025 Cataracts – intraocular lens selection (NG77) Prioritised Guidelines for initial assessment Prioritisation Board recognised that there is good quality evidence on this topic, with recommendations regarding particular types of intraocular lens likely to lead to reduced rates of posterior capsule opacification – a common complication after cataract surgery.
09 April 2025 Chemical adherence testing for apparent resistant hypertension Not prioritised N/A The Prioritisation Board noted that there was only very limited evidence available on this topic and that consequently the topic should not be prioritised. NICE will engage with the NIHR to explore whether additional evidence can be generated on this topic.
09 April 2025 Finger oximetry thresholds Not prioritised N/A Prioritisation Board noted that the recommendations regarding oximeters across NICE’s guideline portfolio contain information regarding the accuracy, proper placement of monitors and warnings about the potential for overestimation in people with darker skin tones. Consequently, they did not feel that updates to the recommendations were required and the topic was not prioritised. They recognised that there is a technology for in-ear oxygen measurement that has been selected as part of the Innovative Devices Access Pathway (IDAP) programme which will be assessed through that process.
09 April 2025 Technologies to support pre-operative and post-operative rehabilitation for patients undergoing hip or knee surgery Prioritised HealthTech Prioritisation Board recognised that the technology in this area has the potential to improve care and reduce waiting times for both pre-operative and post-operative rehabilitation. Consequently, they prioritised this topic.
09 April 2025 Technologies for sampling abnormal cells in the oesophagus Prioritised HealthTech Prioritisation Board recognised that the use of the technology for the surveillance of people with diagnosed Barrett’s oesophagus has the potential for reducing unnecessary endoscopies, thereby saving costs for the NHS and reducing waiting times for endoscopies overall.
09 April 2025 Prolonged grief disorder Prioritised Guidelines for an initial assessment of how the topic should be addressed Prioritisation Board recognised that prolonged grief disorder has significant societal impacts and agreed that a guideline on the topic has the potential to improve outcomes for a large number of people in an area where there is limited guidance available currently.

2024

Prioritisation board meeting dateTopic titleDecisionRouting decisionRationaleDecision publication date
28 February 2024 Esketamine nasal spray for treatment-resistant depression (TA854) Not prioritised N/A Prioritisation board noted that this treatment has been given a negative recommendation previously. It was agreed that the additional evidence available is unlikely to change the existing recommendation. 11 July 2024
28 February 2024 Rheumatoid arthritis Not prioritised N/A Prioritisation board noted that relevant guidance already exists, and the recommendations are not incorrect. System intelligence indicated that TA inclusion is the priority in this space. 11 July 2024
28 February 2024 Familial breast cancer Prioritised Guidelines It was recognised that there is relevant evidence in this area which may lead to new recommendations. There is also a need to ensure consistency with other related NICE guidance. An update offers an opportunity to address inequalities. 11 July 2024
28 February 2024 Vaginal microbiota seeding for neonates Not prioritised N/A Prioritisation board was aware of ongoing research in this area. It was agreed that this is outside the usual remit of the programme and there is a lack of existing methodology to evaluate the procedure. 11 July 2024
28 February 2024 Learning disabilities Not prioritised N/A It was agreed there was limited evidence available to support guidance that would be of value to the system. It was also noted there would be overlap with existing NICE guidelines. 11 July 2024
28 February 2024 Optical coherence Tomography for PCI Withdraw Interventional Procedures Prioritisation board agreed that this is now standard practice with no safety concerns, and that consequently it was appropriate to withdraw the existing Interventional Procedure guidance. 11 July 2024
28 February 2024 Robotic assisted surgery Prioritised for early value assessment HealthTech Prioritisation board agreed there is a system need for guidance in this area and that early value assessments should be developed. 11 July 2024
25 March 2024 Psoriasis Prioritised Guidelines It was recognised there is new evidence that has the potential to affect existing recommendations. Updated guidance should also help to address variation in practice within the system. 11 July 2024
25 March 2024 Psychosocial interventions for autistic children and young people Prioritised Guidelines Prioritisation board agreed that this is an area of unmet need where there would be a significant system benefit of recommendations. 11 July 2024
25 March 2024 Acanthamoeba Keratitis Not prioritised N/A Update 11/10/24 
Prioritisation Board originally did not prioritise this topic. Following a request for clarification, NICE’s Guidance Executive agreed that there is a potential system need for this product and this topic will now be prioritised.
11 July 2024
25 March 2024 Adults in supported living Not prioritised N/A Prioritisation board noted the existing UK government guidance in this area and raised concerns about the availability of suitable evidence to support the development of recommendations. The board also had concerns about system capacity to implement any recommendations. It was agreed not to prioritise the topic at this time but that it may be reconsidered at a later date. 11 July 2024
25 March 2024 Hemochromatosis Not prioritised N/A Prioritisation board were aware of existing EASL and British Society for Haematology guidance in this area and so agreed this is not a priority for NICE currently. 11 July 2024
24 April 2024 Surgical vessel sealing systems Not prioritised HealthTech Prioritisation board agreed that as this is an established technology within the NHS, it may be appropriate for future consideration as a potential topic within the late-stage assessment approach that is being piloted currently. 11 July 2024
24 April 2024 Non-invasive skin closure devices for surgical incisions Not prioritised N/A Prioritisation board agreed that there is limited evidence in this area, and no clear need for system guidance. 11 July 2024
24 April 2024 Bladder EpiCheck for the detection of bladder cancer recurrence Not prioritised N/A Prioritisation board agreed this is not an area of high system priority. There are recently published European guidelines on this topic which do not recommend the technology. 11 July 2024
24 April 2024 Alcohol-use disorders prevention Prioritised Guidelines Prioritisation board agreed there is a system need for current evidence-based guidance in this area. 11 July 2024
24 April 2024 Physical activity in the workplace Not prioritised N/A Prioritisation board agreed that given the challenges of implementing this guidance, it is not a current priority. 11 July 2024
24 April 2024 Obsessive compulsive disorder and body dysmorphic disorder: treatment Prioritised Guidelines Prioritisation board agreed that mental health is a high priority area for the system with the potential for significant population impact. 11 July 2024
29 May 2024 AI for mammography Prioritised HealthTech Prioritisation Board noted there is a growing evidence base in this area with the potential for significant patient and system benefit through the improved detection of breast cancer. 23 August 2024
29 May 2024 Violence and aggression in people with mental health problems Prioritised Guidelines Prioritisation board agreed that there was potential for significant benefits to the system. 11 July 2024
29 May 2024 Management of chronic breathlessness Not prioritised N/A Prioritisation board agreed that there was little evidence relevant to the scope of this topic area, and that the usefulness of a guideline would be limited. 11 July 2024
29 May 2024 Psychosocial distress in people living with cancer Not prioritised N/A Prioritisation board agreed that there would be significant challenges for the system in implementing guidance in this area. 11 July 2024
29 May 2024 Gender incongruence in children and young people Not prioritised N/A Prioritisation board agreed that there was limited value to the system in developing a guideline at this time given the recently published Cass review and a lack of high-quality evidence in this topic area. 11 July 2024
10 June 2024 HST - Duchenne muscular dystrophy - givinostat Not prioritised as a highly specialised technology Technology appraisals Prioritisation board agreed that this didn’t meet the criteria to be considered as a highly specialised technology and that it should be considered as a technology appraisal instead. 11 July 2024
10 June 2024 Familial hypercholesterolaemia Prioritised Guidelines Prioritisation board agreed there was sufficient evidence to support recommendation development. Updated guidance should improve patient outcomes. 11 July 2024
10 June 2024 Digital support for children and young people with eating disorders Prioritised HealthTech Prioritisation board agreed that digital technologies for this group have the potential to address current system challenges. 11 July 2024
24 June 2024 Autism: assessment and diagnosis Prioritised Guidelines Prioritisation board agreed that effective diagnosis is likely to have significant benefit for individuals, their families and carers. They recognised this is an area with significant system need. 11 July 2024
24 June 2024 Autism - digital technologies Not prioritised N/A Prioritisation board confirmed that it was not possible to prioritise guidance on this topic as there are currently no appropriately regulated technologies in this area. 11 July 2024
24 June 2024 Domestic violence and abuse Prioritised Guidelines Prioritisation board agreed this is a topic that has the potential for significant system benefits. Updated guidance is likely to address inequalities. 11 July 2024
24 June 2024 Evoke spinal cord stimulator Not prioritised N/A Prioritisation board noted that guidance development had been paused as the manufacturers could not support it. They noted the existence of similar technologies in this space and limited system need as a result. 11 July 2024
24 June 2024 Peezy midstream Not prioritised N/A Prioritisation board noted that the evidence suggested the technology was not effective for key outcomes. It was agreed that there was no value to the system in producing guidance that did not support the technology. 11 July 2024
08 July 2024 Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory failure in adults Not prioritised N/A Prioritisation board agreed that there was limited evidence available in this area and that an update would be unlikely to change the recommendations. It was agreed some editorial amendments could be made both to the guidance and related maternity guidelines. 12 July 2024
08 July 2024 Extracorporeal membrane oxygenation (ECMO) for acute heart failure in adults Prioritised Interventional procedures Prioritisation board agreed that there was sufficient evidence available which could impact on the existing recommendations. 12 July 2024
08 July 2024 Smoking cessation (digital technologies) Prioritised HealthTech Prioritisation board agreed that there would likely be significant system benefits from developing guidance in this area. 12 July 2024
08 July 2024 Atopic dermatitis (Eczema) - Young people and adults Not prioritised N/A Prioritisation board agreed there is uncertainty about the need for guidance at this time. More needs to be understood regarding potential external guidance in development. The topic will be reconsidered at a later date. 12 July 2024
08 July 2024 Bladder cancer Prioritised Guidelines Prioritisation board agreed there is new evidence in this area which has the potential to impact on the existing recommendations. 12 July 2024
08 July 2024 Type 2 diabetes – insulin therapy Prioritised Guidelines Prioritisation board agreed that there are important clinical questions to address for the system regarding which insulin to use for this population, and when it should be offered. 12 July 2024
24 July 2024 NPi-200 for pupillary light reflex in critical care patients Not prioritised N/A Prioritisation board agreed there was insufficient evidence in this area to develop useful guidance. 5 August 2024
24 July 2024 Lower urinary tract symptoms in men, trans and non-binary people with a prostate: assessment and management Prioritised Guidelines Prioritisation board agreed that this is a large population group where updated recommendations are likely to improve care. 5 August 2024
24 July 2024 Aquablation robotic therapy for lower urinary tract symptoms caused by benign prostatic hyperplasia Not prioritised Guidelines Prioritisation board noted that there is an existing Interventional Procedures guidance on this topic (IPG770). That guidance can be considered for inclusion in the update of the guideline on lower urinary tract symptoms men, trans and non-binary people with a prostate. 5 August 2024
24 July 2024 Surgical site infections – preoperative prophylactic antibiotics plus mechanical bowel preparation Withdraw recommendations regarding antibiotic prophylaxis Guidelines Prioritisation board recognised that the recommendations regarding antibiotic prophylaxis is out of date and there is other relevant external guidance available. NICE will look to collaborate with external partners in relation to this topic. 5 August 2024
24 July 2024 Tumour treating fields for glioblastoma  Not prioritised  N/A Prioritisation Board agreed this was an important area of clinical need, however the evidence is limited and on the basis of the available evidence, the treatment is unlikely to be cost effective. However, the topic should be reconsidered once ongoing trials have completed. 16 August 2024
28 August 2024 Childhood hearing loss Not prioritised N/A Prioritisation Board agreed there is limited evidence available in this area and NHS England has developed an Action Plan on Hearing Loss which addresses care for this population. 18 September 2024
28 August 2024 Visual rehabilitation Not prioritised N/A Prioritisation Board agreed that there is insufficient evidence in this area to develop useful guidance. 18 September 2024
28 August 2024 Health anxiety Not prioritised N/A Prioritisation Board agreed that the topic of health anxiety is likely to be addressed in other planned guidance regarding medically unexplained symptoms and that consequently it should not be prioritised at this time. 18 September 2024
28 August 2024 Hospital transfer when analgesia fails Not prioritised N/A Prioritisation Board agreed that there is insufficient evidence in this area to develop useful guidance and that there does not appear to be a system need. 18 September 2024
28 August 2024 RenalGuard Not prioritised N/A Prioritisation Board agreed that there does not appear to be a significant system need for the technology and that there is the potential for an increased budget impact compared with current clinical practice. 18 September 2024
28 August 2024 Motor neurone disease Not prioritised N/A Prioritisation Board agreed there was insufficient evidence in this area to update the guideline currently. It was agreed it will be reconsidered by Prioritisation Board in the 2026/27 business year. 27 November 2024
28 August 2024 Insertion of a balloon device to disimpact an engaged fetal head before an emergency caesarean section (IPG 515) Withdraw Interventional Procedures Prioritisation Board agreed that as the key trial underpinning the current IP guidance has been withdrawn it is appropriate to withdraw the existing guidance while the update is developed. 27 November 2024
26 September 2024 Strongyloides stercoralis infection Not prioritised N/A Prioritisation Board agreed that there is existing guidance from the UK Health Security Agency (UKHSA) regarding strongyloidiasis infection and so NICE guidance is not required. 11 October 2024
26 September 2024 Avoidant restrictive food intake disorder (ARFID) Not prioritised N/A Prioritisation Board agreed that although this is an important topic, there is currently insufficient evidence for NICE to develop recommendations. NICE will continue to monitor evidence on this topic and revisit it at a subsequent Prioritisation Board meeting in at most two years. 11 October 2024
26 September 2024 Management and prevention of nitrous oxide abuse Not prioritised N/A Prioritisation Board agreed that there are relevant recommendations regarding nitrous oxide use in its guideline on Vitamin B12 deficiency in over 16s (NG239). Consequently, they did not believe that additional guidance is a priority at this time. 11 October 2024
26 September 2024 Digital health technologies for supported self-management of asthma Prioritised HealthTech Prioritisation Board agreed that there is a growing evidence base in this area and system need for guidance on this topic. 11 October 2024
26 September 2024 Omaveloxolone for Friedrich’s ataxia in people 16 years and over (ID6423) No prioritised as a highly specialised technology Technology appraisals Prioritisation Board agreed that the available figures showed that criterion 2 of the highly specialised technologies criteria, regarding eligibility for the treatment, was not met (see appendix 1 of NICE-wide topic prioritisation: the manual). Consequently, it was agreed that the treatment should be routed to the technology appraisals programme. 24 October 2024
16 October 2024 Low calorie diets for type 2 diabetes remission Not prioritised N/A Prioritisation Board acknowledged that this topic has been addressed as part of the update to NICE’s obesity guideline. Consequently they agreed that this topic should not be prioritised at this time but that it could be reconsidered in due course. 24 October 2024
16 October 2024 Non-alcoholic fatty liver disease Prioritised Guidelines Prioritisation Board recognised that there is a significant amount of new evidence in this area and agreed that there is a clear system need for up-to-date guidance on this topic. 24 October 2024
16 October 2024 MAGEC system for spinal lengthening in children with scoliosis Not prioritised N/A Prioritisation Board recognised that NHS England is currently updating its commissioning policy on this topic. Consequently, they agreed it was not appropriate to prioritise an update to this guidance currently. The position will be reviewed after the policy has been updated. 24 October 2024
16 October 2024 Management of oral surgery for people on biological medicines Not prioritised N/A Prioritisation Board agreed that there is very limited clinical and cost-effectiveness evidence in this area. They also noted that prescribing information is available from the British National Formulary and the UK Clinical Pharmacy Association’s Handbook of Perioperative Medicines. Consequently, they agreed that this topic should not be prioritised. 27 November 2024
30 October 2024 PANS/PANDAS Not prioritised N/A Prioritisation Board agreed that there is insufficient evidence in this area to develop useful guidance. 27 November 2024
30 October 2024 Mental health provision for children in care Not prioritised N/A Prioritisation Board agreed that this topic suggestion relates primarily to the development of service delivery models and this is not an area where NICE would be best placed to add value to the system. 27 November 2024
30 October 2024 Tofersen for treating amyotrophic lateral sclerosis caused by SOD1 gene mutations (ID3767) Prioritised as a highly specialised technology Highly specialised technologies Prioritisation Board confirmed that all of the criteria for this to be considered as a highly specialised technology were met. 27 November 2024
30 October 2024 Aspirin for VTE prophylaxis in orthopaedic surgery Prioritised Guidelines Prioritisation Board agreed that there is significant new evidence available and a clear system benefit in addressing this topic with the potential for cost-savings. 27 November 2024
30 October 2024 Alcohol-use disorders: diagnosis and management of physical complications Prioritised Guidelines Prioritisation Board recognised that there is significant new evidence in this area and potential system benefits to updating this guideline. 27 November 2024
28 November 2024 Urgent medicines in care homes Not prioritised N/A Prioritisation Board agreed that the specifics of the topic suggestion were not in NICE’s remit. However, an editorial amendment will be made to the guidance on Managing medicines in care homes (SC1), to clarify that care home medicines policies should include the management of urgent prescriptions. 7 January 2024
28 November 2024 Pitolisant for treating narcolepsy in children and young people 6 to 17 years (ID6353) Not prioritised N/A Prioritisation Board considered the technology at length. It recognised the difference in commissioning of narcolepsy pharmacological treatments between adults and children.

The Prioritisation Board was aware that people with narcolepsy of different ages currently were receiving pitolisant in NHS services.

The Prioritisation Board were concerned that carrying out a Technology Appraisal may create complexity for the system in terms of management of narcolepsy treatments.

The Prioritisation Board therefore concluded that because access exists and there was not an unmet need that it would not be a good use of NICE resources to carry out a Technology Appraisal.
31 January 2024
09 December 2024 Digital health technologies to help manage vasomotor symptoms of menopause Not prioritised N/A Prioritisation Board recognised that there is currently only one regulated technology available and a very limited evidence base. They agreed that this topic should be reconsidered for prioritisation at a later date when more evidence is available. 7 January 2024
09 December 2024 Thermoregulation in people with brain injuries Not prioritised N/A Prioritisation Board recognised that there is only limited evidence available in this area. They also noted that there are a range of different potential mechanisms that could cause impaired temperature regulation and that consequently a single guideline on this topic would be unlikely to be useful and useable. 7 January 2024
09 December 2024 AI and novel technologies in lung function measurement Prioritised Early value assessment Prioritisation Board agreed that this technology has the potential to lead to better clinical outcomes and that there would be value in assessing the technology through an early value assessment. 7 January 2024
09 December 2024 Endoscopic submucosal dissection of lower gastrointestinal lesions Prioritised HeathTech Prioritisation Board recognised the potential improved outcomes from the use of technologies for endoscopic submucosal dissection (ESD) of lower gastrointestinal lesions. 27 November 2024