How will NICE work? And whatever happened to 'beacon' hospitals? Baroness Hayman has the answers. Mark Crail reports

Health ministers speak at dozens of conferences, and even in a government as wedded to policy initiatives as this one they struggle to find something new to say every time.

But a backlog of announcements must be building up at the Department of Health, for junior health minister Baroness Hayman had not one but two pieces of news to impart to an audience last week.

Speaking at a conference on quality run by Birmingham University's health services management centre, she said an order setting up the National Institute for Clinical Excellence would be laid before Parliament that very day.

And - without using the word itself until pressed by a trust chair anxious to know how his organisation could become one - she revealed the fate of the 'beacon hospital' initiative announced by prime minister Tony Blair last July.

NICE, she said, would perform the function of a 'central kite-marking authority, almost', dealing with the growing problem of a 'proliferation of guidelines of varying quality, the uptake of which varies enormously'.

The organisation already had a chair in Professor Sir Michael Rawlins, and the DoH had advertised for a chief executive and non-executive directors, stimulating a 'huge response', with 500 people interested in becoming non-executives.

Because the non-executive mem- bership of the special health authority for NICE would be small, there would also be a 'partnership council' with members from the pharmaceutical industry, the professions and the NHS.

Baroness Hayman acknowledged that it would be easier to deal with new drugs and technologies, but said that questioning existing practices was 'absolutely central to the task we have if we are to utilise resources to best effect'. She added: 'The objectives in all this are very clear, and they are not as sinister as I think some people have thought they might be, and I hope not as threatening as some of the innovators have feared.

'The basic thrust of the proposals is to ensure faster access to modern treatment, and to ensure that innovations which offer those real benefits at fair prices will be actively promoted.'

The DoH had already contracted with the department of public health at Birmingham University 'to scan the horizon for medical innovations'. NICE would then select 20 to 30 of the most significant of these to examine.

'About a year before an innovation is launched on the NHS, we will want the sponsoring company to submit a proposal to NICE.' Where there was no sponsor, the NHS R&D directorate would adopt 'orphan technologies'.

There would be consultation on draft proposals, and the final version would then offer guidance on whether a product was 'suitable for routine use in the NHS, for further research, or not at all', Baroness Hayman told delegates.

'The first few technologies will be referred to NICE in April, and we hope to see advice emerging from the autumn onwards.'

Baroness Hayman said ministers recognised that 'a great deal of useful learning' already happened in the NHS, but innovators often found it expensive and time-consuming to disseminate their work.

Ministers had agreed to spend '£10m a year to identify and promote 100 local health services which we feel are especially innovative and high- quality'. The money would be used 'to reward and spread best practice'.

Asked by a trust chair what had become of the Beacon Hospitals initiative, she said she 'may have left the word 'beacon' out', but essentially this was it. 'We are not looking at whole hospitals but specific services,' she added.

The NHS also had to learn from bad practice. 'The non-success stories we tend to be more diffident about sharing. But learning from experience means learning from experience good and bad.

'We cannot imagine that in an organisation as large and diverse as the NHS we will ever be able to completely eliminate failures of care, but we have a duty when things do go wrong to ensure lessons are learned,' she said.

'I have asked the chief medical officer to establish an expert group to study this issue and report before the end of the year with recommendations for action.'

Baroness Hayman conceded that it would be a lot of work, affecting clinicians, but more particularly managers, planners and educators. It was 'a very, very stretching agenda and it must sometimes be like being asked to do five impossible things before breakfast', but the government's quality agenda was shared throughout the health services.

And the pressures were not just on NHS staff. 'If you are the minister responsible for IT, emergency planning and winter pressures, I tell you the end of this year gives you quite a headache.'