NICE: which way now?

The Wanless report makes it clear that the National Institute for Clinical Excellence will have a 'pivotal' role to play in the way new drugs and technologies are introduced into the NHS.

However, its ringing endorsement comes just as a parliamentary enquiry into NICE is announced, and a public inquiry called for. The Consumers'Association this week demanded an independent inquiry into the way NICE conducts its assessments. A report from the association outlines concerns from patients'organisations about the way appraisals are undertaken, and what needs to change.

It concludes that NICE is not transparent enough in its practice, the patients'perspective is not represented adequately and the process of patients'groups giving evidence is extremely costly.

There were also concerns that NICE guidance is not implemented uniformly and that patients are denied treatments.

The association has called for more clarity in the information needed for appraisals and more transparency about how costings are used in those appraisals. It welcomed the decision of the Commons health select committee to undertake an inquiry into NICE. The committee will look at 'the progress NICE has made in achieving the key goals envisaged in a First-Class Service '. It will examine whether:

it is providing clear and credible guidance;

it has ended confusion by providing a single national focus;

it is providing guidance that is locally owned and acted on in the right way;

it is actively promoting interventions with good evidence of clinical and cost-effectiveness so that patients have faster access to treatments known to work. The committee will also examine the independence of NICE.