Tools and resources

How NICE clinical guidelines are developed: an overview for stakeholders, the public and the NHS

NICE clinical guidelines

NICE clinical guidelines

What is a NICE clinical guideline?

NICE clinical guidelines are recommendations on how healthcare and other professionals should care for people with specific conditions. The recommendations are based on the best available evidence. Clinical guidelines are also important for health service managers and those who commission NHS services.

Our clinical guidelines can cover any aspect of a condition. This may include recommendations about:

  • providing information, education and advice (for example, about self-care)

  • prevention

  • treatment in primary care (GPs and other community services)

  • treatment in secondary care (provided by or in hospitals)

  • treatment in specialised services.

The key principles underlying our clinical guidelines are given in box 1.

Box 1 Key principles underlying NICE clinical guidelines

Our clinical guidelines:

  • aim to improve the quality of care for patients

  • assess how well different treatments and ways of managing a specific condition work

  • assess whether treatments and ways of managing a condition are good value for money for the NHS

  • set out the clinical care that is suitable for most patients with a specific condition using the NHS in England and Wales

  • take account of the views of those who might be affected by the guideline (including healthcare and other professionals, patients and carers, health service managers, NHS trusts, the public, government bodies and the healthcare industry)

  • are based on the best available research evidence and expert consensus

  • are developed using a standard process and standard ways of analysing the evidence, which are respected by the NHS and other stakeholders, including patients

  • make it clear how each recommendation was decided on

  • are advisory rather than compulsory, but should be taken into account by healthcare and other professionals when planning care for individual patients.

A clinical guideline applies to all patients with a particular condition, but there will be times when the recommendations are not appropriate for a particular patient. Healthcare and other professionals are expected to take our clinical guidelines fully into account when exercising their professional judgement. However, the guidance does not override the responsibility of healthcare professionals and others to make decisions appropriate to the circumstances of each patient. These decisions should be made in consultation with, and with the agreement of, the patient and/or their guardian or carer. Healthcare professionals and others should record their reasons for not following clinical guideline recommendations.

Our clinical guidelines are developed for the NHS, but they may also be relevant to professionals working outside the NHS, such as those working in social care.

What are short clinical guidelines?

Most published NICE clinical guidelines are standard clinical guidelines. A standard guideline covers broad aspects of clinical care and the management of specific conditions.

NICE short clinical guidelines address a smaller part of a care pathway. They are produced more quickly, and generally cover areas for which the NHS requires urgent advice. The development of a short clinical guideline is usually coordinated by the Internal Clinical Guidelines Programme at NICE

The details of how standard and short clinical guidelines are developed differ in a number of ways.

The methods and processes described in The guidelines manual and in this overview are those used for producing standard clinical guidelines. Any differences in the short clinical guideline development process are highlighted throughout this overview. These differences are also described in more detail in the document Guide to the short clinical guideline process, which forms appendix M of The guidelines manual.

Different versions of NICE clinical guidelines

Four versions of each clinical guideline are published (see box 2). We also produce tools to support implementation of the guideline in the NHS.

Box 2 Versions of the clinical guideline and support for implementation

The full guideline contains all the background details and evidence for the guideline, as well as the recommendations. It is produced by the National Collaborating Centre or the NICE Internal Clinical Guidelines Programme.

The 'NICE guideline' contains only the recommendations from the full guideline, without the information on methods and evidence.

The NICE pathway is a practical online resource for healthcare and other professionals that contains all the recommendations from a guideline, as well as any other NICE guidance that is directly relevant to the topic. It also contains links to implementation tools and to related NICE guidance and pathways.

'Information for the public' summarises the recommendations in everyday language for patients, their families and carers, and the wider public.

Implementation support tools are produced by NICE to encourage and promote the uptake of guideline recommendations by the NHS.

We publish all versions of the guideline, and the implementation tools, on our website.

How are NICE clinical guidelines developed?

Developing a standard NICE clinical guideline takes 18–24 months from the time we are asked to develop it by the Department of Health or the NHS Commissioning Board to its publication. Developing a short clinical guideline takes 11–13 months.

Key stages of clinical guideline development


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