The white paper Liberating the NHS and the Health Bill currently going through Parliament describe a radically new architecture for the NHS together with a new, outcomes based approach to driving improvements in care.
The bill puts the National Institute for Health and Clinical Excellence at the heart of the government’s plans for the NHS and social care.
NICE quality standards are set to play a significant role right across the health and social care spectrum. These are an important driver for change in the new arrangements for commissioning and service delivery in the NHS.
The first of NICE’s social care quality standards will be published in 2012. They will form part of an integrated suite of support and guidance from the institute, all derived from the same evidence base. This will help those who are commissioning or providing health and social care to achieve the best outcomes.
We will make sure that the indicators in the GP quality and outcomes framework are consistent with those parts of our quality standards that relate to primary care. Similarly, we will ensure that the indicators for the proposed commissioning outcomes framework (which will be used by the NHS Commissioning Board to help hold commissioning consortia to account) will be consistent with the quality standards and the QOF.
All of these products will dovetail, where appropriate, with our proposed work in developing social care standards. In this way, we will be able to achieve a degree of integration and consistency in the resources and incentives for achieving high quality health and social care, which has not been possible in the past.
It is important that the health and social care system receives a clear signal from government about how it is expected to respond to NICE standards. For this reason, we welcome the provision within the bill to set in statute the use of NICE quality standards and, in particular, that the health secretary must have regard to quality standards prepared by NICE.
The government’s plans for health and social care signal a move away from targets and other central controls towards an outcomes based approach to guiding and incentivising good quality care.
In this new environment, commissioners and providers of social care will want to make sure that the decisions they make are informed by good-quality evidence. NHS Evidence, provided by NICE, offers health and social care decision makers access to almost 200 sources. We will work with the Care Quality Commission, Monitor and the Information Centre to make the most of this in the new regulatory system.
The government’s plan to introduce value-based pricing represents a potentially significant change in the relationship between the pharmaceutical industry and the NHS. The government wants the prices paid for new drugs to more closely reflect the value they bring. NICE will play its part at the heart of the new arrangements, continuing to undertake appraisals of the clinical and cost effectiveness of new drugs, alongside a new process of assessing the acceptability of their prices.
Wales, Scotland and Northern Ireland have each developed their own approach to the organisation and management of their health services. They use different combinations of the guidance we produce in ways which reflect their priorities, the needs of their staff and the local resources they have available to inform evidence based practice. We will tailor our relationship in each country and ensure that we have effective working arrangements with the agencies that undertake complementary functions.
In a turbulent environment, it will be important for the institute to retain some important characteristics:
- Unique contribution: clarity about the nature and purpose of our evidence based products;
- Value: products that address the needs of the people, inside and outside the NHS and social care, who use our guidance;
- Clear processes and methods: including transparency, rigour, inclusiveness and contestability;
- Delivery: providing guidance, related products and services in a timely and accessible fashion;
- Flexibility: the ability to respond flexibly to changes in the needs of the people and organisations we serve.
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