Evidence
How we made the decision
How we made the decision
We check our guidelines regularly to ensure they remain up to date. We based the decision on surveillance 5 years after the publication of social and emotional wellbeing: early years (2012) NICE guideline PH40.
For details of the process and update decisions that are available, see ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual.
Surveillance update decisions for the guideline are on our website.
New evidence from 5-year surveillance review on NICE guideline PH40
Two literature searches were undertaken, which identified new evidence from 36 studies:
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A quantitative search strategy considered intervention only studies around resilience, mental wellbeing and transitioning in children, published from 2012 onwards.
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A focused search considered intervention only studies around wellbeing pre-birth published from 2012 as experts and policy documents highlighted that "early years" starts in the womb.
The included evidence did not have an impact on the guideline recommendations.
We considered the views of topic experts, including those who were involved in the development of the guideline and other correspondence we had received since the publication of the guideline.
We checked for ongoing and newly published research from the National Institute for Health Research and Cochrane and new policy developments. No new evidence was identified which would invalidate the guideline recommendations.
Implementation
Nothing identified through implementation feedback indicates a need to update the guideline.
Equalities
No evidence has been found to indicate that the guideline does not comply with anti-discrimination and equalities legislation. During stakeholder consultation one respondent noted that current early years programmes should evaluate the impact of paternal and grandparent involvement in emotional wellbeing programmes. This lack of research was also noted during development of PH40, with the guideline including a recommendation for research asking: 'What approaches can be used to ensure fathers and grandparents help protect or improve the social and emotional wellbeing of vulnerable children aged under 5 years?'
Implications for other NICE programmes
There are two NICE quality standards that used PH40 as a source:
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Postnatal care (July 2013) NICE quality standard 37
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Early years: promoting health and wellbeing in under 5s (August 2016) NICE quality standard 128
The decision to not update PH40 should not have any implications on these quality standards.
Views of topic experts
We considered the views of topic experts, including those who helped to develop the guideline, other correspondence we have received since the publication of the guideline and a meeting was held with Public Health England (PHE) to get its feedback on the guideline. PHE noted the importance of the health visitor's role in early years and discussed evidence on this – this is covered in the Healthy Child Programme, which is recommended in PH40.
Views of stakeholders
Stakeholders commented on the decision not to update the guideline.
See appendix B for stakeholder's comments and our responses.
Four stakeholder organisations responded to the consultation on the review proposal, 2 of whom agreed with the proposal not to update the guideline. Two respondents disagreed with the proposal not to update the guideline on the basis that the guideline does not reflect the current health system structures and that there are recent evidence reviews on early interventions. It is recommended that the guideline is edited to reflect changes in the current health system. The findings described within the two evidence reviews broadly support the current recommendations in PH40.
Overall decision
After considering the guideline content, the views of internal teams within NICE and external experts, the Surveillance team recommend that social and emotional wellbeing: early years (PH40) does not require an update at this time, but should be refreshed to reflect the current health system structures.
For details of the process and update decisions that are available, see ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual.
NICE Centre for Guidelines Surveillance project team
Kay Nolan
Associate Director
Emma McFarlane
Technical Adviser
Charlotte Haynes
Senior Technical Analyst
Victoria Axe
Technical Analyst
The NICE project team would like to thank the topic experts who participated in the surveillance process.
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