Nice does a great job,but the patient experience is essential to the success or otherwise of decisions being made. An example of this is the recent glaucoma guidelines, which has increased the number of referrals now the system is in danger of becoming overwhelmed. Nice really needed to find out just how many optometrist by region were trained to conduct testing? Perhaps they then would have had to acknowledge patients with other serious eye conditions are at risk due to the backlogs being created by the new guidlines. Time for training should have been factored in.
The National Institute for Health and Clinical Excellence (NICE) is internationally renown for its decisions based on cost effectiveness and to an extent the efficiencies of the NHS treatments and interventions. These decisions influence the fiscal state of most trusts, but little evaluation of the impact of each decision (either predicted or discussed during deliberations; collectively with other pathway interventions or singly as a drug or treatment decision) has been published. Perhaps now is the time to provide this information, in addition to the evidence for clinical outcomes, the patient experience should be included as in all NICE guidance provided to date.
Now, more than ever, the NHS must take the time (and assign funds for research and evaluation) to ensure that changes are not undertaken piecemeal without sufficient evidence. The trend toward devolution in UK healthcare has not obviously produced a more efficient NHS - this is an opportunity to review the impact and evaluate the current systems within and across PCTs and determine the best models for the future organisation of services and pathways. The mantra for the NHS and health professionals should be 'evidence, evidence, evidence'.....