As the UK's National Institute for Clinical Excellence (NICE) celebrates its 10th birthday, chairman Professor Sir Michael Rawlins looks back at its successes and ahead to a very exciting time for the organisation. His comments are contained in a Viewpoint published Online First and in an upcoming edition of The Lancet. A Profile of Prof Rawlins has also been published to celebrate the anniversary.
Since being established by then health secretary Frank Dobson on April 1, 1999, NICE has provided guidance for the promotion of good health and for prevention and treatment of ill health to National Health Service (NHS) professionals and those in the public health community. It has published many reports on appraisals of health technologies, including drugs and interventional procedures, and clinical and public health guidelines. Prof Rawlins pays tribute to the 'many thousands of individuals' that have helped develop the institute's national and international reputation for quality.
He says: "Cost effectiveness is generally accepted as being an essential component of decision making. The discussion now is not whether but how the NHS's finite resources should be shared fairly between competing interests." While accepting that criticism has been made of failure to include patients' opinions in this rationing process, Prof Rawlins says that NICE probably involves patients and the public to a greater extent than any other part of the NHS.
The future is looking bright for NICE. The institute's budget is expected to increase significantly over the next few years, largely thanks to recommendations within Lord Darzi's Next Stage Review of the NHS. These will allow NICE to both expand existing programmes and take on new initiatives. Prof Rawlins says: "The most ambitious of NICE's new responsibilities is the construction of NHS Evidence — a web-based portal, analogous to Google, that will enable clinicians, managers, and commissioners to access validated information supporting their work. This portal will provide access to NICE's guidance and to other reliable sources of information developed in the UK and elsewhere."
NICE will also expand its capacity to assess medical devices and diagnostic products, with Prof Rawlins adding: "The NHS needs to be in a position to take advantage of the many benefits these innovative techniques are likely to bring to patients."
Prof Rawlins concludes: "After 10 years, NICE is about to undergo a substantial growth phase. To have been given the opportunity to help steer the institute through the design, beginning, and early stages has been the greatest privilege of my professional career: I am fortunate to be able to continue to do so, for a little longer, as NICE enters its second decade. When Frank Dobson was asked privately, in 1999, whether he thought the idea of NICE would work, he famously replied: 'Probably not—but it's worth a bloody good try'. I think he was right on one count."
See also Profile and two related Comments
For Professor Sir Michael Rawlins, NICE, London, UK please contact the NICE press office T) +44 (0) 845 003 7782 E) pressoffice@nice.org.uk
For Viewpoint, Profile, and both Comments, see: http://press.thelancet.com/nice.pdf
Journal
The Lancet