2 Overview of 2021 surveillance methods

NICE's surveillance team checked whether recommendations in patient experience in adult NHS services (NICE guideline CG138) remain up to date.

The surveillance review of CG138 started in 2019 but was paused in March 2020 when efforts were focused on developing COVID-19 rapid guidelines in response to the pandemic. The review of CG138 resumed in January 2021.

The surveillance process consisted of:

Feedback from topic experts via a questionnaire.
A search for new or updated Cochrane reviews and national policy.
Consideration of evidence from previous surveillance.
Examining related NICE guidance and quality standards and National Institute for Health Research (NIHR) signals or alerts.
A search for ongoing research.
Examining the NICE event tracker for relevant ongoing and published events.
Literature searches to identify relevant evidence.
Assessing the new evidence against current recommendations to determine whether or not to update sections of the guideline, or the whole guideline.
Consulting on the proposal with stakeholders (this document).

For further details about the process and the possible update decisions that are available, see ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual.

2.1 Intelligence gathered during surveillance

2.1.1 Views of topic experts

We considered the views of topic experts who were recruited to the NICE Centre for Guidelines Expert Advisers Panel to represent their specialty. For this surveillance review, topic experts completed a questionnaire about developments in evidence, policy and services related to the guideline.

We received 9 responses questionnaire responses from experts which included 4 consultant physicians, 2 consultant surgeons, 2 specialist nurses, 1 pharmacist and a professor of patient involvement.

Five topic experts thought the guideline should be updated and 4 experts identified that it should not be updated.

The main reasons for indicating the guideline should be updated related to specific points which are discussed in appendix A. Reasons included the following points:

Broaden the patient independence recommendation to cover a greater scope of settings such as custodial or secure patient environments.
Offer patients NHS online feedback to improve patient experience.
Highlight the importance of care records within acute and primary services and the need for shared care records across health providers to improve continuity of care.
Highlight the role of new technologies in providing information, communication and gathering views.
Offer specific guidance on patient experience for older people.

2.2 Evidence considered in surveillance

2.2.1 Search and selection strategy

We searched for new evidence related to the whole guideline.

We found 18 studies in a search for systematic reviews between January 2016 and January 2021.

We also included:

9 studies identified by searches in an Evidence Update (2014) and previous surveillance (2016).

From all sources, we considered 27 studies to be relevant to the guideline.

See Appendix A for details of all evidence considered, and references.

2.2.2 Ongoing research

We checked for relevant ongoing research; of the ongoing studies identified, 1 study was assessed as having the potential to change recommendations. Therefore, we plan to check the publication status regularly and evaluate the impact of the results on current recommendations as quickly as possible. The study is:

Improving the safety and continuity of medicines management at care transitions.

2.3 Equalities

Two equalities issues were identified during the surveillance process, both highlighted by topic experts. They concern the need for specific guidance on patient experience for older people and guidance to cover custodial or secure patient environment settings. These issues are discussed in appendix A.

2.4 Overall surveillance proposal

After considering all evidence and other intelligence and the impact on current recommendations, we propose that no update is necessary.

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Question on Consultation

Question on Consultation

2021 surveillance of patient experience in adult NHS services (NICE guideline GG138)