This year has seen a change in how NICE produces guidance. Previously clinical, public health or social care topics were developed by separate guideline teams, in two different parts of NICE. The need for consistency of approach and the benefits of integrating related topics led to the creation of the centre for guidelines in July 2016.
Following a single, integrated, set of methods and processes, the three programmes have been converging in approach over the last three years and the integration has now been completed by a reorganisation of functions and teams. The process was completed in February 2017.
The centre’s work programme now consists of:
Both the clinical and public health programmes are now switching mostly to updating previous published guidelines, as their portfolios are completed, and the opportunity is being taken to reshape the portfolios to better reflect current service priorities.
In September 2016, we published our first guideline to help healthcare professionals, GPs and physicians care for people who have more than one complex health condition. The guidance includes advice about how to decide between different medicines for common conditions. As well as a database which summarises the benefits and adverse side effects of a number of treatments.
Caring for more people with multiple health conditions, coupled with an ageing population, could require £5 billion in additional expenditure by 2018, according to a 2012 report by the Department of Health.
We recommend developing an individual management plan to help optimise care and treatment in line with the patient’s wishes. This plan will also help the patient prioritise appointments for different conditions and help decide what treatments are appropriate to stop if they offer limited benefit.
In January 2017, we published a guideline to educate the general public in how they can contribute in the battle against antimicrobial resistance.The term 'antimicrobial resistance' is used to reflect what happens when diseases caused by bacteria, viruses and fungi become resistant to the medicines we use to fight them.
With few new drugs being developed one of the key ways to combat antimicrobial resistance is to prescribe and use existing medicines carefully to ensure they remain effective for as long as possible.
The guideline recommends that all children and young people, from pre-school to university age, are taught the importance of hand washing and managing some common infections themselves.
It highlights e-Bug educational software developed by Public Health England, who co-badged the guidance, as a way to help children understand how good hygiene can reduce the spread of disease and the reliance on medicines.
In November 2016, we updated our guideline on low back pain and sciatica. We now recommend people participate in exercises like aerobics or yoga as a way to initially manage the condition.The guideline also recommends encouraging people to continue with normal activities as far as possible. However, the guideline says massage and manipulation should only be used with exercise because there is not enough evidence to show they are of benefit when used alone.
Acupuncture for treating low back pain is not recommended and paracetamol on its own is no longer the first option for managing low back pain. Instead, the guideline recommends that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin should be tried first. Weak opioids, such as codeine, are now only recommended for acute back pain when NSAIDs haven’t worked or aren’t suitable.