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Regulatory aspects
The National Institute for Clinical Excellence (NICE)
  1. A-T Rodgers
  1. National Institute for Clinical Excellence
  1. Correspondence to:
    A-T Rodgers;
    anne-toni.rodgers{at}nice.nhs.uk

https://doi.org/10.1136/ard.61.suppl_2.ii92

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    The National Institute for Clinical Excellence (NICE or the Institute) is part of the UK NHS. It provides guidance for the NHS and patients and their carers that aims to inform decisions about treatment and healthcare. Anne-Toni Rodgers, one of the directors of NICE and an executive lead for many NICE projects, provided an outline of the organisation and the Appraisal Process. In addition she summarised the Institute’s recent guidance on the use of etanercept and infliximab for the treatment of rheumatoid arthritis.

    BACKGROUND: NICE AND THE NHS

    All healthcare workers want to give their patients the best possible care but they face two major problems.

    • The rate of scientific and clinical discovery is so fast that it is hard for people to keep up to date with best practice.

    • The demand for health care is greater than the resources (financial and human) available. This is attributable to past successes, the availability of effective new technologies, and the continued use of older, less effective technologies.

      Every healthcare system in the world is struggling to find solutions to these problems. In Britain, as elsewhere, these problems have meant that healthcare professionals sometimes:

    • started to use new treatments without adequate evidence of their clinical or cost effectiveness

    • continued to use out of date treatments that have been replaced by newer developments

    • have been too slow to introduce new treatments (even when they were shown to be clinically effective and value for money).

    As a result, unacceptable variations in the quality of care available for patients were seen in different parts of the country (so called “postcode” prescribing). The white papers The New NHS Modern and Dependable1and NHS Wales’ Putting Patients First,2 set out the government’s overall agenda for improving the quality of health care in the NHS in England and Wales. More detail …

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