Annie Coppel, Implementation Consultant – North West 15 October 2014

What is NICE? The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for driving improvement and excellence in the health and social care system. New image London Office

Our role Improve outcomes for people using the NHS, public health and social care services Help resolve uncertainty about best quality care and what represents value for money –identify good care and practice using the best available evidence –produce guidance and advice –support practitioners, providers and commissioners to use

Guidelines Evidence Guidelines A set of systematically developed recommendations to guide decisions for a particular area of care or health issue Research studies - experimental and observational, quantitative and qualitative, process evaluations, descriptions of experience, case studies

NICE guidelines Guidelines –Health –Public health –Social care –Medicines practice –Staffing Health Technologies –Technology appraisals (medicines) –Interventional procedures guidance –Medical technologies guidance (devices and some diagnostics) –Diagnostic guidance “NICE guidance sets the standards for high quality healthcare and encourages healthy living. Our guidance can be used by the NHS, local authorities, employers, voluntary groups and anyone else involved in delivering care or promoting wellbeing”

Clinical topics What works and what is value for money Provide recommendations, based on evidence, on how to best identify, refer, diagnose, treat and manage patients Clinical guidelines set out the appropriate clinical care for patients with a specific disease or condition receiving care under the NHS. For example, dementia, autism, pressure ulcers, long term conditions such as diabetes, COPD etc

To promote good health and to prevent ill health - for people working in the NHS, local authorities and the wider public and voluntary sector. Examples of published guidelines: Preventing the uptake of smoking by children and young people Social and emotional wellbeing - early years Domestic violence and abuse - how services can respond effectively Obesity - working with local communities. Contraceptive services with a focus on young people up to the age of 25. Managing overweight and obesity in adults – lifestyle weight management services Public health topics

TopicGuidelines Health and wellbeing of looked after childrenPublished Supporting people to live well with dementiaPublished Autism in children and adultsPublished Mental wellbeing of older people in residential carePublished Managing medicines in care homesPublished Challenging behaviour in people with learning disabilityMay 2015 Home careJuly 2015 Older people with multiple long-term conditionsSept 2015 Children’s attachmentOct 2015 Transition between health and social careNov 2015 Transition from children’s to adults’ servicesMar 2016 Child abuse and neglectMay 2016 Mental health problems in people with learning disabilityOct 2016 Social care topics

Our position in the social care sector Evidence, Guidance, Standards.

Medicines practice

How do we develop guidelines and who is involved

Core principles and process for NICE guidance Based on the best evidence available Expert input Patient, service user and carer involvement Independent advisory committees Genuine consultation Regular review Open and transparent process Publication Validation Consultation Development Scoping Topic referral

Who is involved in developing guidelines? NCC Mental Health GDG GP NCC Cancer GDG National Clinical Guidelines Centre - Acute and Chronic Conditions GDG NCC Women & Children’s GDG NICE Guidelines Team NCC Social Care GDG

Comment on draft guidance and standards All draft guidance and quality standards are consulted on prior to final publication. Register as a stakeholder to comment. Join a working committee Contribute to the production of guidance and quality standards. Vacancies are advertised on our website. Become a NICE Fellow or NICE Scholar Join us for a fixed period, for a day or more each month, to share your expertise, enthuse your colleagues or work upon an agreed research project of mutual interest. In return benefit from NICE’s expertise, mentorship and support. Getting involved with NICE encourages local engagement with relevant topics, fosters a culture of using evidence based guidance, and supports individual professional development. Get involved with NICE

Practical support for use

Managing medicines in care homes

NICE resources to support implementation

Concise information on cost-effective and evidence-based solutions for local government, public health and social care For local authorities and their partner organisations in the health and voluntary sectors Demonstrate potential role of NICE evidence and guidance as the basis of solutions to public health issues and problems at local level Derived from existing guidance Web-based with links to other sources of information. Also printable Introduction Key messages What can local authorities achieve What is effective Examples of good practice Developing an action plan Costs and savings Background to recommendations Support Other useful resources Local Government Briefings

Published 1. Tobacco 2. Workplace health 3. Physical activity 4. Health inequalities and population health 5. NICE guidance and Public Health Outcomes 6. Alcohol 7. Behaviour change 8. Walking and cycling 9. Obesity 10. Tuberculosis in vulnerable groups 11. Social and emotional wellbeing for children and young people 12. Judging whether public health interventions offer value for money 13. BMI thresholds to help prevent illness in black, Asian and minority ethnic groups 14. Improving access to health and care services for those not routinely using them 15. Encouraging NHS Health Checks and supporting people to reduce risk factors 16. Community engagement to improve health 17. Contraceptive services 18. Tackling drug use 19. Looked after children and young people 20. Domestic violence and abuse: how services can respond effectively

NICE Savings and Productivity and Local Practice Collections

Moving on, The Lunch Club experience Moving on, The Lunch Club experience Description: Making a choice about when to move into a dementia care home can be a challenging, frustrating and frightening prospect for many older people. Opening our care home up to the community for lunch club assisting with dispelling myths of care homes, helping with a smooth dignified transition into care. Organisation: The Abbeyfield Society Guidance: QS30 - Supporting people to live well with dementia Implementing a policy for identifying and managing malnutrition in Care Homes Implementing a policy for identifying and managing malnutrition in Care Homes Description: Implementing NICE Clinical Guideline 32 Nutrition support in adults: Oral nutrition support, enteral tube feeding and parenteral nutrition. By supporting staff in care homes we achieved improvements in nutritional management of patients and the reduction in the number of Health Care Professionals consultations for these patients. Organisation: City Healthcare Partnership CIC An ongoing implementation - reducing pressure ulcer prevalence in Birmingham Nursing Homes An ongoing implementation - reducing pressure ulcer prevalence in Birmingham Nursing Homes Description: An increasing prevalence of Pressure Ulcers in Birmingham Nursing Homes was halved by the implementation of a regular Pressure Ulcer Audit Organisation: Birmingham Community Healthcare Guidance: CG29 - Pressure Ulcers Management Go to the Into practice tab on the homepage to find the shared learning link A data base of shared learning examples.

Quality Standards – for quality improvement

Guidelines and quality standards EvidenceGuidelines Quality Standards A prioritised set of statements designed to drive and measure quality improvement. A set of systematically developed recommendations to guide decisions for a particular area of care or health issue Research studies - experimental and observational, quantitative and qualitative, process evaluations, descriptions of experience, case studies

A quality standard Supporting people to live well with dementia

Quality statement 4: leisure activity

Aimed at care providers and carers. Focus on key message from each quality statement Links to key resources, and practical tools Co-produced by Collaborating Centre for Social Care and key people in the social care sector

Help to identify local priorities for quality improvement NICE quality standards can highlight key areas for improvement. An initial assessment of each statement within the quality standard should help you understand: whether the statement is relevant to the organisation how the current service compares to the statement source of information to evidence this what actions/resources would be required to improve the service so that it meets the quality standard statement an initial assessment of risk associated with not making these improvements

Locally prioritised quality improvement An assessment of how the service compares to the quality standard statements: Can provide assurance A positive assessment could be included in the organisation’s quality profile An assessment indicating areas requiring quality improvement can: –inform local quality improvement work/programme planning –support discussions with commissioners Inform the organisation’s audit programme (by identifying priority areas for audit) and business planning Inform local risk management

"As a user of care services, they support me in my choices about who provides care for me, and in knowing what to expect from a good quality care service." "Commissioning services using NICE quality standards allows me to meet my duties as a local authority commissioner to promote integration of health and social care, and support me in ensuring the services I commission are high quality, and value for money” “As a provider of care services, I can use NICE guidance and quality standards to ensure, and therefore demonstrate, that I provide high quality care, based on the best available evidence.” How can quality standards be used ?

InadequateRequires Improvement GoodOutstanding NICE quality standards Standard of services Proportion of services CQC Registration requirements Fundamental Supporting quality improvement

‘Caring for our future: reforming care and support’ ‘By creating a library of social care quality standards we will provide commissioners and providers with evidence-based descriptions of what good care and support should look like. This will also help people using care and support, carers and families to understand what they should expect.’ and ‘NICE and the Care Quality Commission will work together to ensure that related standards (whether quality or regulatory) are complementary.’

NICE QS relate to good and outstanding ratings, and have been used by CQC in developing their forthcoming framework. NICE and the CQC A fresh start for the regulation and inspection of adult social care

. Web based guide to help health & social care organisations use NICE guidance & quality standards to achieve high quality care in local settings Suggests what an organisation can put in place and what staff can do to use NICE guidance & quality standards to improve outcomes & get the best value for money Includes helpful tips, links to other resources and shared learning examples of ways other people have used NICE guidance & standards For commissioners, providers, quality improvement specialists, clinical governance or NICE leads, anyone implementing one specific piece of guidance, anyone planning or scrutinising care services. Guide isn’t intended to be prescriptive or place limitations on what you might choose to do – it’s a good starting point!

Find relevant guidelines and standards

Keeping up to date Sign up for the NICE News Log on to the website and register your details at Register as a Stakeholder for Social Care Guidance and Quality Standards:

Discussion Are you already using any NICE resources? Which and how? Identify 3 ways in which using NICE resources can support your work? What will you do as a result of learning today?