United Kingdom: NICE National Institute for Health and Care Excellence

Andy

Andy

Retired committee member
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There's something I find disquieting about an organisation that feels the need to use the words: bold, ambitious, dynamic and responsive - all in the space of 2 short sentences. Kind of like admitting they were timid, unambitious, sluggish and unresponsive before.
 
Besides providing health guidelines what is the remit of NICE? If their leadership has decided to get serious about reality and providing the kind of guidance that reflects that what other influence do they have in the system that would bode well for thinking that there is a spreading effect through medicine in taking our kind of health issue seriously (in a realistic, finding what really works kind of way) ?
 
Maybe they should start by examining their role in IAPT and look again at the 'evidence';
What is IAPT?
Improving Access to Psychological Therapies (IAPT) services provide evidence-based psychological therapies to people with anxiety disorders and depression.

We assessed digitally enabled therapies for anxiety, depression and medically unexplained symptoms which offer the potential to expand these services further. Read about how we assessed these therapies.
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NICE guidance for conditions managed by IAPT
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https://www.nice.org.uk/about/what-we-do/our-programmes/nice-advice/iapt
 
NelliePledge said:
Interesting the final bullet about influencing the research agenda. Presumably this ties in to the piece in draft guidelines about research priorities.
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They do seem to be in a position to identify what areas of the guideline are not well catered for in terms of treatments (or where evidence is poor). So it seems sensible as they do develop guidelines to identify weak areas as priorities but that feels like it should only be part of the input into a priorization.
 
The NICE strategy 2021 to 2026

Why now?
The world around us has changed and is evolving rapidly. If we’re to stay relevant and remain an international leader in our field, we need a strategy that anticipates, recognises and responds to future changes and challenges.

Added to this, the COVID-19 pandemic changed the UK health and care landscape significantly. The speed at which the crisis gripped our health and care system demanded a new type of response. One that required swiftness and flexibility with constant monitoring of, and reacting to, a changing situation. We rose to the challenge, and the pandemic provided a catalyst for the type of change that we already knew we needed to make.

What will be different?
We’ve developed a vision for the future where we will:

  • Be at the forefront of anticipating and rapidly evaluating new and existing technologies to provide independent, world-leading assessments of value for the system and improved access for patients.
  • Provide dynamic, living guideline recommendations that are useful, useable and rapidly updated. They’ll incorporate the latest evidence and newly recommended technologies to maximise uptake and access for patients.
  • Drive the implementation of our guidance, forming key strategic partnerships to make sure it’s used. We’ll make sure it delivers improvements and contributes to reducing inequalities, with measures to routinely track adoption.
  • Be scientific leaders, driving the research agenda and developing innovative and data-driven methods. We’ll use real-world data to resolve issues of uncertainty and improve access to new innovations for patients.
  • Transform our organisation to make sure we have the infrastructure, skills and capacity to deliver our strategy. We’ll leverage the use of technology to maximise our efficiency and impact.
More at https://www.nice.org.uk/about/who-we-are/corporate-publications/the-nice-strategy-2021-to-2026
 
Andy said:
The NICE strategy 2021 to 2026

Why now?
The world around us has changed and is evolving rapidly. If we’re to stay relevant and remain an international leader in our field, we need a strategy that anticipates, recognises and responds to future changes and challenges.

Added to this, the COVID-19 pandemic changed the UK health and care landscape significantly. The speed at which the crisis gripped our health and care system demanded a new type of response. One that required swiftness and flexibility with constant monitoring of, and reacting to, a changing situation. We rose to the challenge, and the pandemic provided a catalyst for the type of change that we already knew we needed to make.

What will be different?
We’ve developed a vision for the future where we will:

  • Be at the forefront of anticipating and rapidly evaluating new and existing technologies to provide independent, world-leading assessments of value for the system and improved access for patients.
  • Provide dynamic, living guideline recommendations that are useful, useable and rapidly updated. They’ll incorporate the latest evidence and newly recommended technologies to maximise uptake and access for patients.
  • Drive the implementation of our guidance, forming key strategic partnerships to make sure it’s used. We’ll make sure it delivers improvements and contributes to reducing inequalities, with measures to routinely track adoption.
  • Be scientific leaders, driving the research agenda and developing innovative and data-driven methods. We’ll use real-world data to resolve issues of uncertainty and improve access to new innovations for patients.
  • Transform our organisation to make sure we have the infrastructure, skills and capacity to deliver our strategy. We’ll leverage the use of technology to maximise our efficiency and impact.
More at https://www.nice.org.uk/about/who-we-are/corporate-publications/the-nice-strategy-2021-to-2026
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Doing 10/10 on the MBA buzzwords here. Ready the awards for maximizing the synergy of cost-relational benefits in implementing and strategizing wider horizons for impactful results and efficiency.

And other stuff. Just stamp one for Wessely out the gate, there seems to be some sort of automatic process by which he gets awards for no reasons anyone can actually explain.
 
seems like the kind of institutional marketing that happens before privatisation . possibly me just being sceptical .
 
Wearable technologies that monitor Parkinson’s symptoms recommended for use by NHS in England
NICE have conditionally recommended 5 remote monitoring devices for Parkinson’s for use by the NHS in England. Further data on how the devices improve health, quality of life and the cost of care will shape a final recommendation.

The National Institute for Health and Care Excellence (NICE) has said that 5 devices that remotely monitor symptoms of Parkinson’s can be offered by clinicians to people with Parkinson’s.

The devices that NICE has recommended are Kinesia 360, KinesiaU, PDMonitor, Personal KinetiGraph (PKG), and STAT‑ON.
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NICE recommendations
Monitoring symptoms of Parkinson's disease is important to help clinicians make decisions about a person's care. But this can be difficult in current practice because symptoms can come and go and may be difficult to remember or describe. Review appointments may also be infrequent. Sometimes people with Parkinson's disease may struggle to accurately assess their symptoms, and how severe they think they are may differ from the view of their carer (care partner). More objective monitoring of symptoms is therefore an unmet need. Using these devices could help clinicians to better determine when changes to treatment are needed. This may help better manage symptoms of Parkinson's disease and improve quality of life for people with Parkinson's disease and their carers.

There is a lack of evidence about how much of an impact using the devices in the NHS would have on quality of life for both people with Parkinson's disease and their carers. The devices could help save NHS resources, but it is unclear by how much, and which resources. The amount of evidence for each device varies, and no studies compared 1 device against another. PKG has the most evidence, but how effective it would be when used in the NHS is not certain; this is because in the main trial, people who did and did not have the device had more check ups than they would in the NHS. The device was also used more frequently than would be expected in NHS care.

Having early conditional access to these technologies could improve management of symptoms and quality of life for people with Parkinson's disease and their carers. Data should be collected so that the clinical and cost effectiveness of the technologies can be fully assessed. So, the devices are conditionally recommended as an option to help monitor Parkinson's disease.
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I think we need to prioritise research on the use of wearables in ME/CFS clinical care. I note that Parkinsons UK funded the initial studies on the feasibility of wearables. After an initial screening to identify products of sufficient quality, it may be possible to get producers of wearable technology to provide units for free for feasibility studies.
 
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