How NICE supports its guidance Julie Royce Associate Director Implementation Support.

How NICE supports its guidance

Julie Royce

Associate Director Implementation Support

Presentation Content

Range of support provided by NICE

• Think implementation throughout development• Implementation chapter to get people started• Communications support• Teams on the ground – field and HTAP• Practical support – baseline assessment,

resource impact assessment, online learning, podcasts

• Local practice collection• Influencing system change• Partnership

Example Implementation Chapter CG181 Lipids

Example of resources CG37 Postnatal Care

Example shown in NICE pathways

Local problems

• Variation in practice• Local factors • Conflicting priorities • Resource constraints

National Solutions

• The system and NICE influence• Generic practical support• Facilitate shared learning and good practice

NICE prioritisation criteriaImpact/Priority Significant change in practice for

most which:

Reduces harm or address safety concerns?

Conflicts with national policy or existing guidelines?

High impact – eg saves money, resources or significant improvement in outcomes or experience or promote informed choice or equality?

Needs development of new processes, procedures and services rather than improvements?

Significant health improvement? Requires complex interactions across multiple professions, agencies or settings?

Addresses significant variation in practice?

Is contentious?

Challenging but achievable? Requires education or retraining of staff or the development of new skills and competencies?

Developers think it a key priority? Requires significant investment now for long term gain?

What does the implementation science say?

• Guidelines alone do not change practice

• Interventions have minor to modest affects but none in isolation

• Some interventions work some of the time but none all of the time

• Techniques applicableat the national level – eg behaviour change theory

Needs analysis framework – Atrial Fibrillation

At what level is the challenge?

What are the barriers?

What are the enablers?

How were these identified?

What action is feasible for us to undertake?

Team (GPs/practice level)

Systems not in place for risk assessment

Tools, education, peer support through shared learning

Guideline, Stakeholder feedback, developers, NICE fellows and scholars

Partnership with NHS IQ to promote GRASP-AF uptake. Shared learning

Individual Beliefs and values about age and risk.Lack of knowledge and confusion.

Education and training, modelling

Ditto Educational resources, professional organisation, patient decision aid and examples from practice

What is the resource impact?• What is current practice?

• How much change will be needed?

• What could be stopped?

• How much can we save?

• When can it be saved?

• By whom?

• What will it cost to getthe savings?

Questions now?Or see me afterwards

[email protected]