Introduction to NICE: Improving health and well-being by putting science at the heart of health and care decision-making

Keynote on Policy

National Institute for Health and Care Excellence (NICE) was created in 1999 to develop consistent clinical guidelines, make evidence-based recommendations on treatments for the National Health Service (NHS) in England, and address variation in quality and access to treatments. Since then, several key milestones have been reached, including: Our first technology appraisal in 2000, our first guideline in 2002, and more recently, launching our new 5-year strategy in 2021. Over this time, NICE has built a world-class reputation as an international leader in technology evaluation.

NICE’s remit is broad; we produce guidelines and quality standards and make recommendations regarding the provisions of NHS, public health, and social care services in England. NICE delivers training on evidence-based therapeutics to health-care professionals and provides advisory services to bodies such as devolved administrations and pharmaceutical companies. Importantly, there are clear implications of our work for the health-care system. Certain public bodies are required to have regard to NICE guidance and commissioners must make funding available within 3 months of a treatment being recommended by NICE in the technology appraisals and highly specialized technologies programs.

NICE issues advice predominantly to primary and secondary care providers and community health services. This work is generally commissioned by NHS, England, and the Department of Health and Social Care. There are 13 key principles that guide NICE’s work, including the use of independent committees and open consultation with stakeholders.

Our work spans three ecosystems. The first being the Life Sciences ecosystem where we evaluate new technologies, primarily to determine funding decisions. The Guidelines ecosystem is our largest ecosystem and is a continuous process – we routinely track new evidence to keep our recommendations up to date. Finally, the Information ecosystem involves providing access to evidence-based information and expert knowledge, including the British National Formulary.

In 2021, NICE launched a new 5-year strategy. To develop this, we consulted key opinion leaders to assess the changing environment. We identified six key challenges, including: The rapid pace of innovation in health technologies, the digital, data, and real-world evidence revolution, the establishment of Integrated Care Systems, changing collaborations post-COVID and Brexit, increasing focus on tackling health inequalities, and new economic challenges causing a push to optimize resources.

Using this information, NICE created four strategic pillars to help focus our efforts to have the greatest impact. Pillar 1 reflects NICE aim to be at the forefront of rapid, robust, and responsive technology evaluation. Some of our early priorities in this area are to introduce a new Office for Digital Health, explore the use of contingent approval, and create a Life Sciences Hub where this work can be easily accessed. Pillar 2 outlines our aim to provide dynamic, living guideline recommendations to support evidence-based practical improvements to people’s lives, and address health inequalities. Pillar 3 highlights our aim to drive the implementation of our recommendations, forming key partnerships that harness the power of collaboration, encourage its uptake, and increase its impact. And finally, Pillar 4 recognizes that we want to continue to be world leaders in data, research, and science. NICE will continue to set standards for using real-world evidence in our decision-making while also working with our partners to establish data collection activities, particularly where we have identified evidence gaps. We will launch NICE Listens to gather feedback from the public regarding their priorities along with commissioning research around the environmental impact of health technologies.

NICE not only aims to improve health and social care within the UK but also to support countries across the world to improve their health and social care systems through our NICE International advisory service. NICE International supports organizations, ministries, and government agencies globally, to share best practice and help drive improvements in evidence-based decision-making. Services include knowledge transfer through seminars, workshops, and speaking engagements. Scoping exercises and situational analysis offered by NICE International can be a useful tool to gain deeper understanding of a particular issue and can lead to a program of further support. Consultancy support is also available, from reviewing inception and implementation plans to capability building and contextualization of NICE guidelines.

NICE has an ambitious vision for our future, building on the solid foundations of the past 22 years. Successful organizations learn from the environment in which they operate and adapt to the challenges they encounter. We are committed to continue to improve health and well-being by putting science and evidence at the heart of health and care decision-making, while keeping ahead of the challenges of a rapidly changing world.