Managing medicines: NICE

Last updated: Thursday, February 18, 2016

The National Institute for Health and Care Excellence or ‘NICE’ produces guidance and advice to improve health and social care in the NHS in England. Most NICE guidance is also adopted in Wales.

The organisation publishes many different types of guideline, but in this very short introduction we will describe just two types of NICE publication that pharmacists look at regularly:

  • Technology Appraisals (‘TAs’). These are recommendations following a review of clinical and economic evidence. They aren’t just concerned with medicines, but it’s a common subject. Each TA commonly describes one medicine for a specified condition, but sometimes multiple medicines for the same condition. In England, NHS organisations must implement a TA within 3 months of its publication. Essentially this means that the medicine(s) recommended in the TA must be added to the formulary and available to patients within that timeframe. However, exceptions are possible if it’s not likely that the organisation would ever use the medicine(s), e.g. mental health trusts would not be expected to add a medicine for kidney transplants to their formulary. NICE recommendations are summarised in the BNF, and there are also summaries for patients on the NICE website. You can read in detail how TAs are produced here.  

In Scotland, an organisation called the Scottish Medicines Consortium (‘SMC’) has a national role in reviewing medicines. In Wales, there is the All Wales Medicines Strategy Group (AWMSG).

  • NICE clinical guidelines are recommendations on how healthcare and other professionals should care for people with specific conditions. The recommendations are based on the best available evidence. They cover the use of medicines, but also other aspects and interventions such as education, prevention, surgery, and diagnosis. You can read more detail about how these guidelines are developed here.

E-Learning for Healthcare produces a group of learning resources about decision-making and evidence-based healthcare in the context of NICE guidance. It is aimed at medical students, but pharmacists may also find it helpful.

  • Does your formulary show all the medicines that have been approved by NICE? 

  • Find a medicine that has recently been recommended in a NICE TA, and ask a clinical pharmacist or formulary pharmacist how it was implemented at your hospital.

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