Post on 19-Sep-2020
NICE - helping more people to be more active
Deborah O’Callaghan - Implementation Consultant
30th June 2015
Overview
• Brief reminder of the role of NICE
• Highlight resources to support the uptake of physical
activity
• Overview of how these NICE resources can be used to:
– Ensure and provide assurance that services are safe,
effective and value for money
– Inform scrutiny and service review
– Identify high impact areas for improvement
– Develop a clear case for investment (or funding bid)
• A quick guide to accessing NICE guidance and
resources
The role of NICE
• To identify good practice using the best
available evidence
• To help resolve uncertainty for
the public, patients and
professionals
• To reduce variation in the availability
and quality of practice and care
April 2013 – social care
guidance and standards
NICE guidelines
• recommendations based on the best available evidence
to help you plan, deliver and evaluate successful
programmes
• an objective and authoritative summary of the research
and evidence, reviewed by independent experts from a
range of backgrounds and disciplines
• an assessment of the effectiveness and cost
effectiveness of public health interventions
“Following NICE's recommendations on physical activity
will help you make the best and most efficient use of
resources to improve the health of people in your area”
Physical activity guidance
• Exercise referral schemes to promote physical
activity (PH54) (September 2014)
• Four commonly used methods to increase physical
activity (PH2) (March 2006)
• Maintaining a healthy weight and preventing excess weight
gain among adults and children(NG7) (March 2015)
• Maternal and child nutrition (PH11) (March 2008)
• Obesity (CG43) (December 2006)
• Physical activity and the environment (PH8) (January 2008)
• Physical activity: brief advice for adults in primary
care (PH44) (May 2013)
Physical activity guidance cont.
• Prevention of cardiovascular disease (PH25) (June 2010)
• Promoting physical activity for children and young
people (PH17) (January 2009)
• Promoting physical activity in the workplace(PH13) (May
2008)
• Walking and cycling: local measures to promote walking
and cycling as forms of travel or recreation (PH41)
(November 2012)
• Weight management before, during and after
pregnancy (PH27) (July 2010)
Maintaining a healthy weight and preventing
excess weight gain among adults and children –
March 2015
1 Encourage people to make changes in line with existing advice
2 Encourage physical activity habits to avoid low energy expenditure
3 Encourage dietary habits that reduce the risk of excess energy intake
4 Further advice for parents and carers of children and young people
5 Encourage adults to limit the amount of alcohol they drink
6 Encourage self-monitoring
7 Clearly communicate the benefits of maintaining a healthy weight
8 Clearly communicate the benefits of gradual improvements to
physical activity and dietary habits
9 Tailor messages for specific groups
10 Ensure activities are integrated with the local strategic approach to
obesity
NICE pathways
NICE Pathways
NICE Pathways
• present all NICE guidance for a
specific subject
• include NICE guidance and NICE
quality standards
• Link to NICE implementation
resources (e.g. costing and
commissioning resources, training
resources)
• offer an easy and intuitive way to
access NICE guidance
Quality standards
Physical Activity Quality Standards
• Physical activity: encouraging activity in all people in
contact with the NHS (March 2015)
• Mental wellbeing of older people in care homes (Dec 2013)
• Falls in older people – Assessment and prevention (March
2015)
• Antenatal Care (Sept 2012)
• Postnatal Care (July 2013)
• Diabetes in adults (March 2011)
What are NICE guidance and quality
standards?
Evidence Guidance Quality
Standards
A NICE quality standard is a
concise set of statements
designed to drive and
measure priority quality
improvements.
A set of systematically developed
recommendations to guide decisions for
a particular area of care or health issue
Research studies - experimental
and observational, quantitative
and qualitative, process
evaluations, descriptions of
experience, case studies
Source guidance
• Behaviour change: individual approaches (2014) NICE
guideline PH49
• Physical activity: brief advice for adults in primary
care (2013) NICE guideline PH44
• Walking and cycling: local measures to promote walking
and cycling as forms of travel or recreation (2012) NICE
guideline PH41
• Promoting physical activity for children and young
people (2009) NICE guideline PH17
• Promoting physical activity in the workplace (2008) NICE
guideline PH13
Domain Objectives and indicators
1 Improving the wider determinants of health
ObjectiveImprovements against wider factors which affect health and wellbeing and health inequalitiesIndicators1.9 Sickness absence rate1.16 Utilisation of outdoor space for exercise/health reasons1.18 Social isolation* (ASCOF 1I)
2 Health improvement ObjectivePeople are helped to live healthy lifestyles, make healthy choices and reduce health inequalitiesIndicators2.5 Child development at 2–2½ years2.6 Excess weight in 4–5 and 10–11 year olds2.8 Emotional wellbeing of looked after children2.12 Excess weight in adults2.13 Proportion of physically active and inactive adults2.17 Recorded diabetes2.22 Take up of the NHS Health Check programme – by those eligible2.23 Self-reported wellbeing2.24 Injuries due to falls in people aged 65 and over
4 Healthcare public health and preventing premature mortality
ObjectiveReduced numbers of people living with preventable ill health and people dying prematurely, while reducing the gap between communitiesIndicators4.4 Under 75 mortality rate from all cardiovascular diseases (including heart disease and stroke)** (NHSOF 1.1)4.5 Under 75 mortality rate from cancer** (NHSOF 1.4i)4.7 Under 75 mortality rate from respiratory diseases** (NHSOF 1.2)4.11 Emergency readmissions within 30 days of discharge from hospital** (NHSOF 3b)
Driving quality improvement work
What are NICE guidance and quality
standards?
Evidence Guidance Quality
Standards
A NICE quality standard is a
concise set of statements
designed to drive and
measure priority quality
improvements.
A set of systematically developed
recommendations to guide decisions for
a particular area of care or health issue
Research studies - experimental
and observational, quantitative
and qualitative, process
evaluations, descriptions of
experience, case studies
How to use NICE quality standards
Help to identify local priorities for quality improvement
• NICE quality standards can highlight key areas for
improvement. An initial assessment should consider:
– relevance to the organisation
– how services compare
– what evidence is available
– actions to improve
– risks of not improving
Sources of information to support initial
assessment could include:
• baseline assessments/actions plans for NICE clinical
guidelines
• new or existing service user feedback
• complaints or Serious Untoward Incidents (SUIs)
• audit information (including national audit data)
• prescribing or activity data
• views of the service/team
• process maps
• service user experience interviews
The initial assessment
• A positive assessment can:
– provide assurance
– could be included in the trust’s quality account or
organisation’s quality profile
• An assessment indicating areas requiring quality
improvement can:
– inform local quality improvement work/programme
planning
– support discussions with commissioners
• Inform the organisation’s annual audit programme (by
identifying priority areas for audit) and business planning
• Inform local risk management, in collaboration with the
service’s commissioners
Do we require our service providers to include advice about physical activity in the feedback that we give to parents?
Is this reflected in the service specification?What is the content of the advice – does it include information about local
opportunities to be physically active?What format is this advice in and at what stage is it given?
Endorsement statement for Living well through activity
in care homes
“This toolkit supports statements on participating in
meaningful activity and personal identity in the NICE quality
standard for mental wellbeing of older people in care
homes. In addition, it also supports the recommendations
relating to occupational therapy interventions and training
within the NICE guideline onmental wellbeing in over
65s: occupational therapy and physical activity
interventions”
National Institute for Health and Care Excellence
June 2015
Scrutiny and service review
NICE guidance & quality standards can provide a useful
reference tool for those scrutinising services
Ask services:
• whether they have a systematic approach to NICE
guidance and quality standards, and what it is
• how they are using NICE quality standards to improve
quality of care provided or commissioned
• specific questions developed from quality standard
statements
Case study – Greater Manchester Sector
Led Improvement
• NICE guidance & quality standards are pivotal to Greater
Manchester's sector-led improvement approach to driving
improvements in public health
• Process of self-assessment and peer review
• Local action plans are developed and reviewed regularly
by LA peers to ensure that NICE guidance & quality
standards are being implemented and that performance
against PHOF (Public Health Outcomes Framework)
measures improves in the long-term
Practical Support
Into Practice Guide
Self assessment/Audit tools
Costing reports and templates
Online learning resources
Case scenarios
Shared learning database
Medicines Information
NICE and BNF apps
Field team
We provide a range of resources to help local implementation of our guidance and
use of our quality standards.
www.nice.org.uk/about/what-we-do/into-practice
Implementation - practical support
Shared learning
• My best move – GP training for physical activity for
patients with long term conditions (NHS London)
• Implementation of NICE guidance on promoting physical
activity in young people (NHS Oxfordshire)
• National database to evaluate the effectiveness of
outdoor activity based initiatives (Natural England)
• Leicester Square to Covent Garden walking corridor
(Westminster City Council)
• Walking away from type 2 diabetes (Loughborough Diet
Lifestyle and Physical activity Biomedical Research Unit)
• Community based Falls Prevention in Older People
(Anglesey County Council)
Return on Investment Tools
• Each tool enables the user to evaluate a
portfolio of interventions in their geographical
area and models the economic returns that can
be expected in different payback timescales
• 3 published so far:– Tobacco
– Alcohol
– Physical Activity
Local Government briefings
• These briefings provide advice for local
government on the public health actions that are
most effective and provide best value for money,
based on NICE guidelines
• Briefly summarise NICE recommendations
• Outline prevalence and high level costs and
savings
• High impact ‘vignettes’
• Links to other useful resources and advice
Physical activity related briefings
• Physical activity
• Walking and cycling
• Encouraging people to have NHS Health Checks and
supporting them to reduce risk factors
• Behaviour change
• Preventing obesity and helping people to manage their
weight
• Workplace health
• Community engagement to improve health
• Health inequalities and population health
• Tackling the causes of premature mortality
Physical activity (LGB 3)
• Introduction
• What can local authorities achieve by encouraging
people to be more physically active?
• What NICE says
• Developing an action plan
• Costs and savings
• Facts and figures
• Support for planning, review and scrutiny
• Other useful resources and advice
“In England, the costs of lost productivity have been
estimated at £6.5 billion per year from sickness absence
and premature death.
Physical activity programmes at work have been found to
reduce absenteeism by up to 20%: physically active
workers take 27% fewer sick days. Getting employees
involved in a physical activity programme can also lead to
net savings while boosting productivity”
“There is potential for increasing the number of journeys
taken by bicycle. Currently, these trips make up just 2% of
all journeys in Britain. Twenty percent of all trips made
cover less than 1 mile – and just over half of all car
journeys cover less than 5 miles (Transport trends 2009).
Although most children can cycle, only 2% of trips to school
are made by bike (Taking part: The national survey of
culture, leisure and sport. Adult and child report
2009/2010)”
Behaviour change
• Behaviour change interventions are coordinated sets of
activities that seek to change specific health-related
behaviours.
• What to consider when commissioning behaviour
change interventions and programmes
• What NICE says
• Developing an action plan
• Costs and savings
• Support for planning, review and scrutiny
• Other useful resources and advice
If you can’t find what you’re
looking for….
Keeping up to date• Sign up for the NICE News
• Log on to the website and register your details at
www.nice.org.uk
• Register as a Stakeholder for Social Care Guidance and
Quality Standards: socialcaresh@nice.org.uk
• Email: deborah.ocallaghan@nice.org.uk