National Institiue for Health and Clinical Excellence

Annual Review - 2009/2010

Chairman's and Chief Executive's foreword

After nearly a decade of expansion, the National Health Service is taking a long, hard look at how it can continue to increase the quality of care it provides against a backdrop of tightening budgets. NICE has a key role to play in helping it do so.

Contributing to the quality and productivity of the NHS has always been part of the role of NICE. We are in the business of sorting out what is effective – from both clinical and cost standpoints – from what is not. It is not simply about cutting costs. We provide clear, authoritative evidence-based information for those that commission and provide care to ensure not only that the money they spend improves health for their communities, but also – just as importantly – that they do not spend money on ineffective care. This is reflected not only in our guidance-producing centres, but also in the wide range of new work-streams that have been started this year.

Over the past year we have produced 13 clinical guidelines, 17 technology appraisals, advice on the use of 42 interventional procedures and four public health guidelines. Following our guidance is the best possible way for organisations to deliver quality care for patients, and we show service providers how they can best spend their resources.

We have also reviewed what we offer the NHS and wider public health community in the light of an imminent tightening of resources. We have talked to people in the NHS about what they need from us so we can plan changes to the way in which we develop and present our advice, and make access to it easier. From identifying specific recommendations that can save money, to advice on reconfiguration to support disinvestment from clinically ineffective services, we have a range of products and services to help realise savings that can be reinvested into patient care.

In the short term, we have increased the profile of our cost-saving recommendations, which in recent years add up to many millions of pounds of savings across a range of clinical practice, freeing up resources and capacity that can be used for other services.

We are particularly proud of the success of NHS Evidence, launched in April 2009. This exciting new service provides web access to all the best clinical evidence, non-clinical evidence and best practice, including recommendations on improving productivity. Over 10 million searches have already been carried out by users, and more than 5,000 healthcare professionals have registered to personalise their version of the site. As well as access to accredited guidance from NICE and other providers, NHS Evidence includes about 200 examples of cost-saving changes in the nature and delivery of clinical practice. Changes in the care of patients with strokes, for example, can reduce both deaths and lengths of hospital stays.

Our guidance continues to have an international reputation and profile, reflected in requests for advice from our consultancy arm, NICE International, from the health departments in Turkey, Colombia, China and elsewhere.

In addition to our guidance, new initiatives started this year are also playing a key role in helping the NHS improve quality and productivity. Consultation has taken place on the new Quality Standards due to be published later in 2010. 

These will provide a set of concise, measurable statements about high-quality care to be used by professionals, providers and patients. We are also now responsible for setting the clinical and cost-effectiveness indicators for the Quality and Outcomes Framework, the incentive scheme for general practice.

And we are ready to start our new medical technologies programme, which will provide much-needed advice on the effectiveness of new devices and diagnostics, paving the way for a more uniform and joined-up approach to their use in the NHS.

This substantial increase in our work and outputs would not be possible without the dedicated support of our stakeholders – NHS colleagues, patient organisations or our committee and board members – and our staff. It is once again our duty and our pleasure to thank them for their commitment and dedication to their work, to NICE, to the NHS and to the health of the nation.

Professor Sir Michael Rawlins
Sir Andrew Dillon CBE Chief Executive