Who we are and what we do
1. The National Institute for Health and Care Excellence (NICE) helps practitioners and commissioners get the best care to people, fast, while ensuring value for the taxpayer. We do this by:
- producing useful and usable guidance for health and care practitioners
- providing rigorous, independent assessment of complex evidence for new health technologies
- developing recommendations that focus on what matters most and drive innovation into the hands of health and care practitioners
- encouraging the uptake of best practice to improve outcomes for everyone.
The principles that guide our work
2. We are consistent in our approach, developing our guidance and standards at pace and in accordance with a set of core principles that underpin all of our work.
Principle 1. We prepare guidance and standards on topics that reflect national priorities for health and care.
Principle 2. We describe our approach in process and methods manuals and review them regularly.
Principle 3. We use independent advisory committees to develop recommendations.
Principle 4. We take into account the advice and experience of people using services and their carers or advocates, health and social care professionals, commissioners, providers and the public.
Principle 5. We offer people interested in the topic the opportunity to comment on and influence our recommendations.
Principle 6. We use evidence that is relevant, reliable and robust.
Principle 7. We base our recommendations on an assessment of population benefits and value for money.
Principle 8. We support innovation in the provision and organisation of health and social care services.
Principle 9. We aim to reduce health inequalities.
Principle 10. We consider whether it is appropriate to make different recommendations for different groups of people.
Principle 11. We propose new research questions and data collection to resolve uncertainties in the evidence.
Principle 12. We publish and disseminate our recommendations and provide support to encourage their adoption.
Principle 13. We assess the need to update our recommendations in line with new evidence.
Our methods and processes
3. Our independent advisory committees make difficult decisions, striking a balance between effectiveness and the best use of limited public funding. They take a rigorous and structured approach, based on transparent processes and methods that are published on our website. We keep our methods and processes up to date by reviewing them regularly and consulting on changes with our stakeholders.
How we involve people
4. As part of our decision-making process, we take into account the experiences, expertise and views of the people who will be affected by our work. This includes patients and patient organisations, carers and members of the public, as well as health and social care practitioners and representatives of NHS organisations, industry, social care businesses and local government.
5. We make decisions based on evidence and we welcome constructive challenge and a broad range of views. Our consultation process enables individuals and organisations to comment on drafts of our recommendations throughout the guidance development process. Our guidance is created by independent and unbiased advisory committees. These include experts such as clinicians, health economists and social workers, patients and carers or other members of the public. We also hear testimony from patient and clinical experts as part of the evidence we consider.
6. Through effective involvement and engagement, we put the needs and preferences of patients and the public at the heart of our work. Our Public Involvement and Engagement Programme supports patients, carers, and members of the public, as well as voluntary, charitable and community organisations to inform and engage with NICE’s work.
Working with system partners
7. NICE works closely with system partner organisations including NHS England, the Medicines and Healthcare products Regulatory Agency, the Care Quality Commission, UK Health Security Agency, the Office for Health Improvement and Disparities, the Associations of Directors of Adult and Children’s Social Services, the royal colleges, and devolved administrations. By forming key strategic partnerships, we harness the power of collaboration to maximise our impact and value to the health and care system.
Working with evidence and driving the research agenda
8. We are an essential part of a health and care system that is always learning from data and implementation. We quality appraise and analyse a wide range of evidence to inform our work. We support new data collections to address areas of uncertainty and continue to increase and extend the use of data in the development and evaluation of our guidance. This includes making use of electronic health record data and real-world data, for example. We keep abreast of technological developments to assess whether new sources of potentially relevant evidence may be useful in the development or evaluation of our guidance.
9. We proactively seek to drive the research agenda and funding priorities. We collaborate with academia, government and industry to ensure that issues of most relevance to NICE's methods and patient care are addressed.
10. We want to use real-world data to resolve gaps in knowledge and drive forward access to innovations for people. Our real-world evidence framework advances the use of real-world evidence in our guidance by identifying when we can use real-world data to reduce uncertainties and improve guidance. It describes best-practices for developers when planning, conducting, and reporting real-world evidence studies.
11. Through our early value assessments for healthtech, we identify promising medical technologies, recommending them for early NHS use while further real-world evidence is gathered. When we have the evidence needed, we make a full recommendation for using the technology.
12. Our health technology assessment innovation laboratory enables NICE to develop creative ways to evaluate technically complex new treatments that cannot easily be assessed using our existing methods alone. It offers a ‘safe space’ for creating solutions in collaboration with system partners and stakeholders. By harnessing the ideas of our stakeholder community, we can solve complex health technology assessment issues, taking innovation from the lab and into practice.
Our international role
13. We are at the global forefront of health technology assessment and guideline development. We collaborate with international health organisations, ministries and government agencies, representing the UK on the world stage. Through NICE International, we provide global support to help other countries improve their nation’s health and care. NICE teams are encouraged and supported to proactively establish international collaborative relationships and projects aligned with NICE’s strategic priorities.
Environmental sustainability
14. We play an important and influential role in shaping what treatments, technologies and processes the NHS adopts, setting best practice for healthcare professionals. This makes NICE well placed to support the NHS's commitment to achieve net zero carbon emissions by 2040 for direct emissions and 2045 for indirect emissions.
Working with the life sciences industry
15. We work at the interface of health and care and the life sciences industry to facilitate earlier, faster access to innovation that represents value to the taxpayer. Much of what NICE does has an impact on the life sciences industry that supplies the NHS. We are conscious of the responsibility we carry when we advise the NHS on the use of health technologies. We know that what we say about new technologies is often considered by health systems elsewhere in the world. Given the important benefits to the healthcare system of effective new technologies, we work with industry associations and companies in the UK and internationally to build mutual respect and trust.
16. NICE scans the horizon, identifying future transformational care for the benefit of patients. We share information when appropriate about new medicines, medical devices, diagnostics and digital products with national partner organisations. This supports NHS budget and service planning, which enables the faster uptake of innovations across the NHS.
17. Our life sciences support service, NICE Advice, works with life sciences companies on a fee-for-service basis. From value proposition to evidence generation and market access, we work collaboratively with industry partners to drive innovation into the hands of health and care professionals.
18. NICE’s commercial liaison team supports the development of commercial agreements between NHS England and life science companies for the technologies we are evaluating.
19. Our managed access team supports companies in designing their data collection plans for managed access agreements. We also work in partnership with NHS England to operate the Cancer Drugs Fund and Innovative Medicines Fund. The funds provide routes for access to new medicines that require a further period of evidence-collection before a final decision can be made about their routine use.
The status of our guidance
20. Different types of NICE guidance have a different status within the NHS, public health and social care. Our technology appraisals and highly specialised technologies guidance are unique because integrated care boards, NHS England and local authorities are required to fund and resource medicines and treatments recommended through these programmes. The legal status of this mandatory funding is set out in the NHS Constitution and the Health and Social Care Act 2012. The NHS Constitution states that patients have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if the doctor responsible for the patient’s care says they are clinically appropriate. The Health and Social Care Act 2012 also states that the Secretary of State and the NHS Commissioning Board (now NHS England) should have regard to the quality standards prepared by NICE as part of their duty to secure continuous improvement in the quality of services.
21. The introduction of selected health technologies that NICE recommends can also be accompanied by the Medtech Funding Mandate. This is agreed by NHS England and not mandated in legislation.
22. Health and social care professionals are actively encouraged to follow the recommendations in our other types of guidance to help them deliver the highest quality care. Of course, our recommendations are not intended to replace the professional expertise and clinical judgement of health professionals, as they discuss treatment options with their patients.
Communicating about our guidance, standards and other resources
23. We disseminate and clearly communicate our guidance and other products to those responsible for putting them into practice. We raise awareness of the value of our work with system partners and stakeholder organisations. We also promote our work and explain the role evidence-based care plays in improving health outcomes to the wider public.
24. Through our audience insights and user feedback work, we ensure that the views and expectations of NICE’s stakeholders are systematically gathered and interpreted.
25. Patients, people using services, carers and the public can also use NICE guidance and other products as a guide to the high-quality care they should expect to receive.
26. To ensure our guidance is accessible and useful, we continue to review and innovate how our guidance is structured and presented.
Putting our recommendations into practice
27. Used effectively, NICE resources can support demonstrable improvements in health and social care outcomes, support productivity, and contribute to the national drive to reduce health inequalities.
28. Our guidance is relevant to charities, voluntary and community organisations, residential care homes, private sector employers, patients, carers, service users and the public as well as the NHS and local government. We provide support (directly and through partnerships) to put our recommendations into practice.
29. For example, we work with key health system partners to ensure our guidance is embedded into regulation, monitoring and quality improvement frameworks. We also facilitate the availability of support tools and resources which help practitioners and commissioners to implement our guidance and better understand unwarranted variation in uptake of NICE-recommended treatments and interventions. We also work with organisations, networks and regional partners to encourage, inform and facilitate their implementation activities on a local level.
30. Sometimes our guidance may recommend changes in practice which the NHS, local government and social care providers and commissioners may find difficult to implement. NICE is committed to supporting commissioners and providers, local authorities, and organisations in the wider public and voluntary sector to make the best use of resources and will continue to co-design programmes of support that will ensure we can get the best care to people fast, while ensuring value to the taxpayer.