NICE process and methods

12 Support for putting the guideline recommendations into practice

12 Support for putting the guideline recommendations into practice

12.1 Introduction

Our purpose is to help practitioners and commissioners get the best care to people fast, while ensuring value for the taxpayer. The NICE strategy for 2021 to 2026 outlines the importance for our guidance to provide useful and useable advice and for it to purposefully influence the health and care system to adopt the best possible care. To achieve this, we will transform by targeting 3 key areas:

  • focusing on what matters most

  • creating advice that's useful and useable

  • continually learning from data and implementation.

We support the implementation of guidelines by gathering system intelligence, understanding uptake, disseminating guidelines through networks, sharing actionable insight and best practice, and responding to implementation challenges. We work in partnership with key stakeholders to provide a focused number of implementation support resources that have been tested by our users and will have the greatest impact on the system.

Implementation is considered from the guideline monitoring and scoping stages and throughout the guideline development process.

We work with committees, organisations and stakeholders from all relevant sectors to identify potential implementation challenges and consider solutions to address them. For some topics, we work with organisations to develop resources to support implementation, to signpost to existing resources, to embed recommendations in policy documents and to raise awareness with key stakeholders. This chapter outlines some of the resources and support available to help health and care practitioners, commissioners, patients, the public and the voluntary and community sector to use NICE guidelines.

12.2 Tools for planning and resource impact assessment

We provide a baseline assessment tool for each guideline at the time of publication. Organisations can use the tool to identify whether they are in line with NICE guideline recommendations, and to help them plan and record activity to implement them.

We have developed a resource planner to help users plan for and implement our guidance by listing forthcoming guidance, and summarising the resource impact of published guidance and when available those in development.

NICE resource impact assessment tools help organisations assess the potential costs, savings and capacity impacts associated with implementing a guideline. For guidelines that will have a significant resource impact, a resource impact report and resource impact template are produced, where data allows. A guideline's resource impact is significant if the national cost is more than £1 million per year for a single recommendation or £5 million per year for the whole guideline. When costs and savings cannot be quantified but the resource impact may be significant, a resource impact summary report is produced. If the guideline's resource impact is not significant, a 1-page resource impact statement is produced.

12.3 Into practice resources

Visual summaries

For some guidelines, a visual summary of part of the guideline is produced for health or care practitioners. This might happen if practice needs to change, a practitioner needs to make quick decisions, or a specific audience needs support in implementing the recommendations. Examples include a summary showing how the technology appraisals on lung cancer drugs fit together, treatments for more severe depression in adults and antimicrobial prescribing for Clostridioides difficile infection.

Quick guides

We have previously produced quick guides for some social care topics. They aim to help practitioners to implement recommendations (for example, in care homes) or to support people using services to understand what to expect and make decisions about their care.

Patient decision aids

If a guideline contains a highly preference-sensitive decision point, we include information in the guideline to make it easier for professionals and practitioners to discuss options with the person making a decision on care (see the section on supporting shared decision making in the chapter on interpreting the evidence and writing the guideline). Occasionally we develop a separate patient decision aid to support shared decision making by the person and their health or care practitioner. See our web page on making decisions about your care for the process guide and a list of our patient decision aids.

Case studies

NICE case studies support NICE guideline implementation in areas where we have identified a specific implementation or health inequalities challenge. They show how a team or individual has implemented recommendations, addressing these challenges and the learning from their experience. They are published on the tools and resources tab of the guideline and are reviewed in line with any guideline updates.

Into practice guide

Our into practice guide shows how to use evidence to improve care and services. It sets out the most common steps taken when putting evidence-based guidance into practice.

12.4 Assessing and measuring the use of NICE guidance

Several tools are available which aim to address variation in care:

We use a range of data to measure the uptake and impact of NICE guidance. Examples include NHS England's Secure Data Environment (SDE), other national data collections, clinical audit, and data from journals. Intelligence and feedback from users of our guidance and strategic partners also provide insights on the use of our guidance.

12.5 Working with organisations to support implementation

We are strengthening external collaboration so that opportunities for implementation are maximised, for example, by aligning with organisational regulation, monitoring and improvement frameworks.

If other organisations produce resources to support guideline implementation we work with them to ensure that the NICE guideline is correctly referenced and embedded within the resource and signpost to it from the NICE website, if possible.

Implementation support is prioritised to reflect the priorities and needs of the health and care system.

Organisations from all sectors and individuals, both lay and practitioner, play a key role in supporting guideline implementation. We work with external organisations in the following ways to help to put all NICE guidance and quality standards into practice:

  • The national implementation team work with key national partners to identify barriers to, and priorities for, implementation. The team develop implementation support resources and solutions to help practitioners and commissioners to use NICE products.

  • The system implementation team supports regional and local health and care systems to implement NICE guidance and use quality standards. The team are regionally based and work with partners to provide feedback and intelligence to NICE on the views of stakeholders.

  • The medicines optimisation team supports the implementation of NICE products and provides feedback and intelligence to NICE from the NHS and other stakeholders, with a specific focus on medicines optimisation. It does this through national, regional and local networks, such as the NICE medicines and prescribing associates.

  • An implementation strategy group comprised of external academics and practitioners provides expertise and feedback on our implementation activities and keeps the organisation updated on new and ongoing developments in implementation science.

  • The people and communities team works with national and local voluntary and community sector organisations and members of the public to raise awareness of our guidance and standards, promote their use, and support implementation.

We also actively seek feedback from people who use our guidelines to improve guidelines and implementation resources. We welcome system intelligence and information about any of our guidelines or broader topic areas and use this to inform our monitoring and topic intelligence work. This enables us to prioritise our guideline updates and implementation support work.