Tucked away in the Health and Social Care Bill on the government’s proposals to transfer the role of commissioning patient services from primary care trusts to GP-led consortia, are plans to reform the National Institute for Health and Clinical Excellence (NICE).
NICE, currently a special health authority will be re-established as a statutory non-departmental public body corporate. To reflect the broadening of NICE’s remit to provide guidance for the social care sector, the body’s name will change to the National Institute for Health and Care Excellence, although still called NICE.
In exercising its functions in an effective, efficient and economical fashion, NICE must continue to have regard to:
The broad cost-benefit balance in the provision of health or social care services in England
The degree of need individuals have for such services
The desirability of promoting innovation in the provision of health services and social care.
The NHS will eventually commission NICE to develop quality standards (statements defining high quality, cost effective care for a particular condition) for NHS care, and public health and social care. NICE will have a duty to establish a process for the preparation of quality standards on all NHS hospitals and clinics. The quality standards will have statutory status.
NICE will be able to give advice or guidance, provide information or make recommendations on matters relating to the provision of NHS services, public health services or social care. This may include guidance on new and existing medicines, treatments and procedures, and treating and caring for people with specific diseases and conditions or with particular social care needs. It may also enable NICE to publish or disseminate advice, guidance, information or recommendations to the NHS, local authorities or other organisations in the public, private, voluntary or community sectors on how to improve people's health and prevent illness and disease.
Regulations may be made requiring specified public bodies to have regard to NICE advice, guidance, information or recommendations or to comply with NICE’s recommendations.
Put simply, NICE will move from a body that rations drugs, to controller of NHS quality on everything.
NICE is important to private medical insurers as some only pay for drugs and treatment approved by NICE.
Private medical insurance news: 24 February 2011