NICE update. Paul Chrisp, Programme Director, Medicines and Prescribing Centre

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1 NICE update Paul Chrisp, Programme Director, Medicines and Prescribing Centre

2 Outline NICE offers a comprehensive suite of guidance, advice and support for delivering quality, safety and efficiency in the use of medicines: Evidence services on nice.org.uk Evidence summaries Key therapeutic topics Medicines practice guidelines BNF Associate programme Student champions scheme

3 Evidence services

4 Evidence services

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6 Evidence services

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9 Evidence summaries: new medicines Aim: help local decision-making and planning on the introduction of key new medicines Quality-assured summaries of the best available evidence for selected new medicines, or existing medicines with new indications or a new formulation, considered to be of significance to the NHS Medicines recently introduced in the UK, or may be introduced in the next 6-12 months Only considered if a TA is not planned or in progress [unless an appraisal consultation document (ACD) won t be published within 6 months of launch] Not formal NICE guidance

10 Evidence summaries: unlicensed/offlabel medicines (ESUOMs) Aim: allow evidence-based prioritisation, treatment and funding decisions to be made where there are no clinically-appropriate licensed alternatives Summarise the best available evidence for selected unlicensed and off-label medicines The first nationally-available source of information for healthcare professionals and patients Not formal NICE guidance

11 ESUOMs prioritisation criteria Demand for information: what is the volume of requests from the NHS for information on the topic? Clinical impact: what is the potential of the medicine (if effective) to improve significantly the quality of life for the people in whom it might be used? Variation in practice: is there large unwarranted variation in clinical practice, significant divergence of clinical opinion, or reports of difficulty of access to the unlicensed or off-label medicine? Need for information: how much uncertainty exists on the risk: benefit balance of the unlicensed or off-label medicine?

12 Key therapeutic topics Aim: to inform local medicines optimisation activity Since 2010 Support the DH QIPP medicines use and procurement workstream Now led by NHS England, part of medicines optimisation Summarise the evidence base in areas where there are potential opportunities for maintaining or improving quality and improving value Signpost to H&SCIC prescribing indicators, where available Recently consulted on which to retain, retire or update

13 Key therapeutic topics Laxatives Renin-angiotensin system drugs Lipid modifying drugs Omega-3 fatty acid supplements High dose inhaled corticosteroids in asthma Hypnotics Low dose antipsychotics in people with dementia First-choice antidepressant use in adults with depression or generalised anxiety disorder Antibacterial prescribing especially quinolones and cephalosporins Three-day courses of trimethoprim for uncomplicated urinary tract infection Minocycline Type 2 diabetes mellitus Non-steroidal anti-inflammatory drugs (NSAIDs) Wound care products

14 Medicines practice guidelines Aim: to provide advice and guide good practice for those involved in handling, prescribing, commissioning and making decisions about medicines Developing and updating local formularies Patient group directions Managing medicines in care homes Safe use and management of CDs (Dec 2015) Medicines optimisation (short clinical guideline; March 2015) Antimicrobial stewardship (May 2015)

15 BNF Aim: to ensure prescribers have timely access to accurate and up to date information on medicines, and provide the right information, in the right format, in the right place, at the right time: Build on BNF s position NICE accredited Consistent with NICE guidance Open, transparent processes Better exploit digital and mobile delivery Not getting rid of print!

16 Associates programme Aim: to support and promote high quality, safe, costeffective prescribing and medicines optimisation within local health economies. Associates work within their own organisation and their local health economy to: support the adoption of NICE and other high-quality guidance into practice and reduce inappropriate variation in prescribing across localities highlight issues of medicines safety, risk and never events to improve medicines safety support the local managed introduction of new medicines develop leadership, facilitation, decision-making and management skills Supported by Regional Technical Advisers

17 Regional Technical Advisers North of England & Northern Ireland Louise Picton: (from 1 st July) Midlands, East of England & Wales Gill Eddy: Gill.Eddy@nice.org.uk London Michelle Liddy: Michelle.Liddy@nice.org.uk South of England and Channel Islands Zoe Girdis: Zoe.Girdis@nice.org.uk

18 Student champions scheme Aim: to increase uptake of evidence resources through a programme of education and support Peer to peer model Independent evaluation (MMU) indicated value of scheme, supported model, halo effect of NICE association, potential for extension of advocacy role, recommended co-facilitation 22 universities participated in 2013/14, involving 250 champions and 1500 cascade students Demand outstripping capacity Proposal that UKMI becomes a co-delivery partner

19 Summary NICE offers a lot to help you Looking forward to ongoing relationship with UKMi Thank you