Annie Coppel, Implementation Consultant – North West

15 October 2014

What is NICE?

The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for

driving improvement and excellence in the health and

social care system.

New image London Office

Our role

• Improve outcomes for people using the NHS, public health and social care services

• Help resolve uncertainty about best quality care and what represents value for money

– identify good care and practice using the best available evidence

– produce guidance and advice – support practitioners, providers and commissioners

to use

Guidelines

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

NICE guidelines

• Guidelines – Health – Public health – Social care– Medicines practice– Staffing

• Health Technologies– Technology appraisals (medicines)– Interventional procedures guidance– Medical technologies guidance (devices and some diagnostics)– Diagnostic guidance

“NICE guidance sets the standards for high quality healthcare and encourages healthy living.

Our guidance can be used by the NHS, local authorities, employers, voluntary groups and anyone else involved in delivering care or promoting wellbeing”

Clinical topics

•What works and what is value for money

•Provide recommendations, based on evidence, on how to best identify, refer, diagnose, treat and manage patients

Clinical guidelines set out the appropriate clinical care for patients with a specific disease or condition receiving care under the NHS. For example, dementia, autism, pressure ulcers, long term conditions such as diabetes, COPD etc

To promote good health and to prevent ill health - for people working in the NHS, local authorities and the wider public and voluntary sector.

Examples of published guidelines:

•Preventing the uptake of smoking by children and young people

•Social and emotional wellbeing - early years

•Domestic violence and abuse - how services can respond effectively

•Obesity - working with local communities.

•Contraceptive services with a focus on young people up to the age of 25.

•Managing overweight and obesity in adults – lifestyle weight management services

Public health topics

Topic Guidelines

Health and wellbeing of looked after children Published

Supporting people to live well with dementia Published

Autism in children and adults Published

Mental wellbeing of older people in residential care Published

Managing medicines in care homes Published

Challenging behaviour in people with learning disability May 2015

Home care July 2015

Older people with multiple long-term conditions Sept 2015

Children’s attachment Oct 2015

Transition between health and social care Nov 2015

Transition from children’s to adults’ services Mar 2016

Child abuse and neglect May 2016

Mental health problems in people with learning disability

Oct 2016

Social care topics

Our position in the social care sectorEvidence,Guidance, Standards.

Medicines practice

How do we develop guidelines and who is involved

Core principles and process for NICE guidance

• Based on the best evidence available

• Expert input

• Patient, service user and carer involvement

• Independent advisory committees

• Genuine consultation

• Regular review

• Open and transparent processPublication

Validation

Consultation

Development

Scoping

Topic referral

Who is involved in developing guidelines?

NCC MentalHealth

GDG

GDG

GDG GDG

GDG

GP

NCC Cancer

GDG

GDG GDG

GDG

GDG

GDG

GDG

National Clinical Guidelines

Centre -Acute and

Chronic Conditions

GDG

GDG

GDG GDG

GDG

GDG

GDG

GDG

GDG

GDG

GDG

NCC Women & Children’s

GDG

GDG

GDG

GDGGDG

GDG

GDG

NICE Guidelines

Team

NCC Social Care

GDG

GDG

GDG

GDG

Comment on draft guidance and standardsAll draft guidance and quality standards are consulted on prior to final publication. Register as a stakeholderto comment.

Join a working committeeContribute to the production of guidance and quality standards. Vacancies are advertised on our website.

Become a NICE Fellow or NICE Scholar Join us for a fixed period, for a day or more each month, to share your expertise, enthuse your colleagues or work upon an agreed research project of mutual interest. In return benefit from NICE’s expertise, mentorship and support.

Getting involved with NICE encourages local engagement with relevant topics, fosters a culture of using evidence based guidance, and supports individual professional development. www.nice.org.uk/getinvolved

Get involved with NICE

Practical support for use

Managing medicines in care homes

NICE resources to support implementation

• Concise information on cost-effective and evidence-based solutions for local government, public health and social care

• For local authorities and their partner organisations in the health and voluntary sectors

• Demonstrate potential role of NICE evidence and guidance as the basis of solutions to public health issues and problems at local level

• Derived from existing guidance

• Web-based with links to other sources of information. Also printable

• Introduction

• Key messages

• What can local authorities achieve

• What is effective

• Examples of good practice

• Developing an action plan

• Costs and savings

• Background to recommendations

• Support

• Other useful resources

Local Government Briefings

www.nice.org.uk/lgb

Published

1. Tobacco

2. Workplace health

3. Physical activity

4. Health inequalities and population health

5. NICE guidance and Public Health Outcomes

6. Alcohol

7. Behaviour change

8. Walking and cycling

9. Obesity

10. Tuberculosis in vulnerable groups

11. Social and emotional wellbeing for children and young people

12. Judging whether public health interventions offer value for money

13. BMI thresholds to help prevent illness in black, Asian and minority ethnic groups

14. Improving access to health and care services for those not routinely using them

15. Encouraging NHS Health Checks and supporting people to reduce risk factors

16. Community engagement to improve health

17. Contraceptive services

18. Tackling drug use

19. Looked after children and young people

20. Domestic violence and abuse: how services can respond effectively

NICE Savings and Productivity and Local Practice Collections

Moving on, The Lunch Club experienceDescription: Making a choice about when to move into a dementia care home can be a challenging, frustrating and frightening prospect for many older people. Opening our care home up to the community for lunch club assisting with dispelling myths of care homes, helping with a smooth dignified transition into care.Organisation: The Abbeyfield SocietyGuidance: QS30 - Supporting people to live well with dementia

Implementing a policy for identifying and managing malnutrition in Care HomesDescription: Implementing NICE Clinical Guideline 32 Nutrition support in adults: Oral nutrition support, enteral tube feeding and parenteral nutrition. By supporting staff in care homes we achieved improvements in nutritional management of patients and the reduction in the number of Health Care Professionals consultations for these patients. Organisation: City Healthcare Partnership CIC

An ongoing implementation - reducing pressure ulcer prevalence in Birmingham Nursing HomesDescription: An increasing prevalence of Pressure Ulcers in Birmingham Nursing Homes was halved by the implementation of a regular Pressure Ulcer AuditOrganisation: Birmingham Community HealthcareGuidance: CG29 - Pressure Ulcers Management

Go to the Into practice tab on the homepage to find the shared learning link

A data base of shared learning examples.

Quality Standards – for quality improvement

Guidelines and quality standards

A prioritised set of statements designed to drive and measure quality improvement.

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

A quality standardSupporting people to live well with dementia

Quality statement 4: leisure activity

• Aimed at care providers and carers.

• Focus on key message from each quality statement

• Links to key resources, and practical tools

• Co-produced by Collaborating Centre for Social Care and key people in the social care sector

Help to identify local priorities for quality improvement

NICE quality standards can highlight key areas for improvement.

An initial assessment of each statement within the quality standard should help you understand:•whether the statement is relevant to the organisation•how the current service compares to the statement•source of information to evidence this •what actions/resources would be required to improve the service so that it meets the quality standard statement•an initial assessment of risk associated with not making these improvements

Locally prioritised quality improvement

An assessment of how the service compares to the quality standard statements:

•Can provide assurance

•A positive assessment could be included in the 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 audit programme (by identifying priority areas for audit) and business planning

•Inform local risk management

"As a user of care services, they support me

in my choices about who provides care for me, and in knowing what to expect from a good quality care service."

"Commissioning services using NICE quality standards allows me to meet my duties as a

local authority commissioner to promote integration of health and social care, and

support me in ensuring the services I commission are high quality, and value for

money”

“As a provider of care services, I can use NICE

guidance and quality standards to ensure, and

therefore demonstrate, that I provide high quality care,

based on the best available evidence.”

How can quality standards be used ?

Inadequate Requires Improvement

Good Outstanding

NICE quality standards

Standard of services

Proportion of services

CQC Registration requirements

Fundamental

Supporting quality improvement

‘Caring for our future: reforming care and support’

‘By creating a library of social care quality standards we will provide commissioners and providers with evidence-based

descriptions of what good care and support should look like. This will also help people using care and support, carers and

families to understand what they should expect.’

and‘NICE and the Care Quality Commission will work together to ensure that related standards (whether quality or regulatory)

are complementary.’

NICE QS relate to good and outstanding ratings, and have been used by CQC in developing their forthcoming framework.

NICE and the CQCA fresh start for the regulation and inspection of adult social care

.

• Web based guide to help health & social care organisations use NICE guidance & quality standards to achieve high quality care in local settings

• Suggests what an organisation can put in place and what staff can do to use NICE guidance & quality standards to improve outcomes & get the best value for money

• Includes helpful tips, links to other resources and shared learning examples of ways other people have used NICE guidance & standards

• For commissioners, providers, quality improvement specialists, clinical governance or NICE leads, anyone implementing one specific piece of guidance, anyone planning or scrutinising care services.

• Guide isn’t intended to be prescriptive or place limitations on what you might choose to do – it’s a good starting point!

www.nice.org.uk/intopracticeguide

Find relevant guidelines and standards

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: annie.coppel@nice.org.uk

Discussion

• Are you already using any NICE resources? Which and how?

• Identify 3 ways in which using NICE resources can support your work?

• What will you do as a result of learning today?