NICE: Triennial Review

The Department of Health have now published its report on the NICE Triennial Review.

This report looks at what NICE does and how. The Accelerated Access Review will consider how NICE appraises and approves medicines and medical devices. The Triennial Review did not consider the methodologies and processes used by NICE or NICE’s role in promoting and disseminating innovations.

The main conclusion reached is that NICE performs necessary functions and should continue to operate as an executive non-departmental public body. The tenor of the evidence gathered throughout the review was that NICE is a respected and valued organisation with an important role to play, particularly in financially constrained times. Most of the comments were made in the context of the organisation not being considered ‘broken’ in any way but with the ability to enhance what it does and how it operates further.

The following recommendations were made (we have bolded those we feel are most relevant to subscribers)

  • NICE works with the Department and the Cabinet Office Commercial Models team to explore opportunities for greater expansion of NICE International and NICE Scientific Advice and consider whether these functions could be delivered more effectively.
  • NICE should work with the Department and NHS England to develop and publish a set of key performance indicators that reflect strategic objectives and assess the impact of the organisation, which are supported by appropriate input, output, or other performance targets [in 2015/16]
  • NICE should work with other health and care leaders; especially NHS England, Public Health England and Care Quality Commission (CQC), to align the approach to implementation of NICE guidance and recommendations in order to support organisations in implementation activity [by the end of 2015]
  • DH should consider the clinical and cost effectiveness appraisals currently conducted within the health and care system, including (but not limited to) the Cancer Drugs Fund (CDF) and the Joint Commission on 8 Vaccinations and Immunisation (JCVI), with a view to establishing whether NICE should be the single expert body with responsibility for such appraisals [by April 2016]

  • Following the findings of the Accelerated Access Review, the Department of Health and NICE, with input from NHS England, should consider what changes to NICE’s methods and processes are necessary to enable the health and care system make best use of the resources available [by July 2016]

  • NICE should increase its profile, work more flexibly and further develop relationships across the sector [not with industry specifically]
  • NICE should continue to work with patient groups
  • NICE should continue to improve communications and engagement work with social care stakeholders
  • NICE should work with the Medicines and Healthcare Products Regulatory Agency (MHRA) to review the partnership agreement and consider publicising both the agreement and steps taken to ensure the principles are put into practice throughout all levels of the organisations
  • NICE should work with NHS England to identify systems and processes, with associated metrics where appropriate, to secure the application of commitment in the Partnership Agreement to using NICE guidance in the centralised and devolved commissioning arrangements

  • NICE should work to further enhance relationships with organisations across health and care
  • In order to ensure effective governance of the organisation, including its independent advisory committees, NICE should:
    • Arrange an externally facilitated assessment of the effectiveness of the Board which gives consideration to whether additional expertise is required and how future thinking becomes an integral part of the Board’s activity [by April 2016]
    • Ensure that the arrangements for operating and quality controlling the work of the independent advisory committees are robust and transparent, publishing these arrangements where feasible [by July 2016]
  • In order to explore opportunities for further efficiencies:

    • The Accelerated Access Review should consider the advantages and disadvantages arising from charging industry for health technology appraisals and medical devices and diagnostics evaluations

    • NICE should investigate the possibility of benchmarking functions with international comparators. [By July 2016].

The full report can be read here.

Annexes to the main report can be read here.

Published on 22. July 2015 in News UK