Quality standards: process guide

1.1 What is a NICE quality standard?

NICE quality standards describe high-priority areas for quality improvement in a defined care or service area. Each standard consists of a set of specific, concise statements and related measures that are:

Evidence from the underpinning guidance relating to people's experience of care or services, safety issues, equality and resource impact is considered during the development process.

NICE quality standards do not provide a comprehensive service specification. They define priority areas for quality improvement based on consideration of the topic area.

1.2 Components of a quality standard

There are 2 main components to a quality standard: the quality statements and the quality measures. Each quality standard typically contains 5 quality statements with related measures.

Quality statements are clear, measurable and concise. Most quality statements describe 'enhanced practice', which is both aspirational and achievable. A minority of quality statements describe 'developmental practice', which indicates outstanding performance. Developmental statements focus on cutting-edge service delivery or technology requiring specific and significant changes over time to lead to wide-spread benefits.

Each quality statement specifies 1 concept or requirement for high-quality care or service provision (for example, a single intervention, action or event). In exceptional circumstances a statement may contain 2 concepts or requirements if they are closely linked (for example, treatment or service options that depend on the results of an assessment).

Quality measures accompany each quality statement, and can be used to assess the quality of care or service provision specified in the statement.

In addition, each statement is accompanied by a description of its implications for different audiences (service providers, health, public health and social care practitioners, commissioners, people using services and carers), the guidance used, the sources of data for measurement, definitions of the terms used and, where relevant, equality and diversity considerations.

1.3 Using quality standards

NICE quality standards provide clear descriptions of high-priority areas for quality improvement. They help organisations improve quality by supporting comparison of current performance, using measures of best practice to identify priorities for improvement, and can provide information for commissioners and providers on how best practice can be used to support high-quality care or services.

They may also demonstrate practice that has the potential to have wide-spread benefits in improving outcomes over time, but may require specific changes to be put in place, thereby helping organisations to improve quality in the longer term.

NICE quality standards are not mandatory but they can be used for a wide range of purposes both locally and nationally. For example:

Although the standards are not targets, providers and commissioners should have due regard to them when planning and delivering services, as part of a general duty to secure continuous improvement in quality. Organisations from the independent sector may also consider using the quality standards to ensure that the services they provide are of high quality.

The development of NICE quality standards includes a consideration of outcomes, as presented in relevant frameworks such as the NHS Outcomes Framework, Public Health Outcomes Framework and Social Care Outcomes Framework.

NHS England and Improvement has also committed to making NICE quality standards an integral part of its plans to improve quality over the next 5 years (NHS Five year forward view). NICE works closely with the Care Quality Commission (CQC) to ensure consistency between their inspections and the NICE quality standards. NICE quality statements describing enhanced practice can be used to demonstrate good services during a CQC inspection. Statements describing developmental practice can indicate an outstanding service. Further information on how quality standards are used by the CQC is available on the NICE website.

1.4 Key principles and activities of the NICE Quality Standards Programme

NICE operates the Quality Standards Programme according to its core principles. These include:

The key activities of the Quality Standards Programme are to: