Dissemination of information to stakeholders- the NICE experienceSarah Garner, Associate Director, Research and Development

What are challenges to uptake?• Information overload• Limited resources• Organisational issues• Cultural and political • Clinicians’ acceptance• Patients’ acceptance• Bureaucracy• Language• Evidence!• Interpretation• The unexpected!

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pathways

Recommended examples highlighted

Quicklinks 

section

The use of multi-channel cystometry, ambulatory urodynamics or videourodynamics is not recommended before starting conservative treatment.

Implementation Tools

• Money- costing templates and reports- commissioning guides

• Advice- slide sets

- implementation advice- ‘How To’ guides

– Shared learning database

• Planning- horizon scanning– Forward planner– themes

North Eastern

Implementation Consultants • Seven consultants based in the

field - the ‘local face’ of NICE

• Providing the NHS and Local Authorities with updates, advice and support for local strategies for implementation

• Feedback to NICE about barriers, successes and ways to improve what we do

East

London & South EastSouth West

West

North Western

The NICE Field team – proactively working with guidance users

111 Directors of Public

Health last year

Costing template – adjust local figuresCosting template for stroke

Notes Unit cost (£) Units Total cost

(£) Unit cost (£) UnitsTotal cost

(£) Unit cost £ Units Total cost

(£)

Blue cells shoud be amended to reflectlocal circumstances

*1 Total population 50,542,505 1,710,426 1,710,426

*2 Estimated incidence of TIA per 1000 0.51 0.51 0.62 Annual incidence of TIA 25,777 872 1,060

*3 Annual incidence of stroke 110,000 3,723 4,000

Carotid endarterectomy for people with minor (non-disabling) stroke or TIA

Current number of carotid endarterectomy procedures per year 4,061 137 137 *4 Estimated current cost £3,434 4,061 £13,945,474 £3,434 137 £470,458 £3,434 137 £470,458

TIA patients eligible*5 Proportion with attacks in the carotid territory 80% 20,622 80% 698 80% 848 *6 Stenosis of 50–99% 15% 3,093 15% 105 15% 127

Stroke patients eligible*7 Proportion with ischaemic stroke 85% 93,500 85% 3,165 85% 3,400 *8 Proportion with minor (non-disabling) stroke 25% 23,375 25% 791 25% 850 *5 Proportion with attacks in the carotid territory 80% 18,700 80% 633 80% 680 *6 Stenosis of 50–99% 15% 2,805 15% 95 15% 102

Estimated total eligible patients 5,898 200 229 *9 Less cases identified by DoH -1,031 -35 -35

*4 Proposed cost of carotid endarterectomy procedures £3,434 4,867 £16,713,278 £3,434 165 £566,986 £3,434 194 £666,572

Proposed costs less current costs £2,767,804 £96,528 £196,114

Anticipated savings - carotid endarterectomy

England [Enter the name of your locality here] [Enter the name of your locality here]

Cost for selected population using standard assumptions

Cost for selected population using local assumptions

Using the forward plannerThe forward planner helps people plan for and implement NICE guidance by:

•summarising published guidance organisations may still be implementing •listing forthcoming guidance to help NHS bodies plan ahead The forward planner is an Excel spreadsheet. The data can be sorted by any column. ‘Auto filter' has been added to the file so that types of data can be selected, such as published guidance, or technology appraisals.

http://www.nice.org.uk/page.aspx?o=298522

Forward planner

The commissioning guides

• Provide or signpost information on key clinical and service-related issues for commissioners to consider – underpinned by the relevant guidance.

• Contain a commissioning tool - interactive resource to help estimate and inform the level of service needed locally, as well as the cost of local commissioning decisions. Registration required

Topic specific and web-based

• Small project group• Commissioned literature

review• Held workshop with end

users• Targeted consultation

Part 1: Understand the barriers to change

• Barriers out of our control –the external environment

Part 2: Identify the barriers to change

Part 3:Overcome the barriers to change

• strategies

New NICE initiatives...

• A ‘one-stop’ resource for cost saving practice on NHS Evidence (for the DH quality and productivity programme)

• NICE care pathways published through NHS Evidence• Service delivery recommendations with clinical

guidelines• New guidance on when to refer and treat• More visible ‘don’t do’ recommendations in guidance• Better prioritisation of potential cost saving topics• Productivity news alerts via the NICE website