The NICE Annual Conference was held at the end of last month in Manchester. This is a good opportunity to catch-up on what NICE has been up to over the past past year. The conference showcases the latest developments in clinical improvement, health technologies and patient-centred quality care, providing insight into the innovations shaping healthcare, such as digital technology, patient empowerment, real world evidence and big data.
The conference was opened by Sir David Haslam, the chair of NICE, who spoke about the need to design care around people, and the development of person-centred guidance based on evidence. The NHS aspires to excellence, and this is critical to how the NHS is viewed externally. Innovators are supported by NICE to ensure they get their products to the people who need them quickly via schemes such as EAMS, the CDF and the new health technology appraisal process. The NHS needs to free-up time and resource to allow for the humanity of healthcare.
There followed a panel discussion chaired by Dr Phil Hammond about uniting the science and the practice of clinical improvement. How to link NICE guidance and evidence to improve care, the role of evidence in setting clinical policy and designing care pathways, and the tension between financial pressures and quality improvement.
In the breakout session about life sciences, Jennifer Prescott from NICE introduced the new NICE health technology appraisal process for 2018. The process was implemented in April this year, in a bid to improve the efficiency of the four NICE appraisal committees as the number of new technologies reviewed by NICE increases from around 55/year to 75/year. The addition of a technical report and earlier engagement with companies and experts to reduce uncertainties surrounding the data is expected to give faster access to new drugs and a final appraisal document (after one committee meeting) within 6 months. The first technology to go through the process is cabozantinib for liver cancer.
There was also an interesting session on shared decision-making, which, apparently, is at the heart of everything NICE does! Shared decision-making involves conversations between clinician and patient around personal preferences, options, benefits, risk and consequences leading to an informed decision. Around 40% of patients have not made an informed decision about entering a treatment pathway. Patients want to be involved with decisions about their treatment and there is a difference between what clinicians think the patient wants and what the patient actually wants. However, shared decision-making will need a fundamental shift in roles, relationships, responsibilities and attitudes to enable doctors and patients to work together. NICE are planning to introduce guidelines for shared decision-making, and work on this will start in August 2018 with the view to publishing guidance in 2021. In the meantime, CCGs, health science networks, medical students and patient organisations need awareness and education of shared decision-making practices.
Other interesting sessions included the Canadian example of the collection of real world data for use in health technology appraisals, and an update on the Accelerated Access Review and horizon scanning for new life science technologies in the UK.