NICE guidelines & service based research in the NHS

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Golightly
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NICE guidelines & service based research in the NHS

Post by Golightly » Sun Mar 18, 2018 12:08 pm

Hi all,

Apologies if this sounds a bit of a naive question but it's one that's been floating around in my head for a few days now. I work in Ireland and have no experience of the NHS but am reading around how things work within it at the moment.

One big difference that I can see between the Irish health service (HSE) and the NHS is the emphasis placed on practice in line with NICE guidelines. Within HSE services, in my experience, there is quite a bit of service-based research- reviewing the literature and assessing the effectiveness out evidence-based (but perhaps not strongly backed by NICE guidelines) interventions within services (e.g. group Acceptance and Commitment Therapy for anxiety). I wondered what it's like for people working psychologically within NHS services - is there still scope for these initiatives?

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MarkM
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Re: NICE guidelines & service based research in the NHS

Post by MarkM » Sun Mar 18, 2018 1:05 pm

Hi Golightly,

I don't think it's a naive question and I'm actually really curious to hear other people's experiences -- mine have varied in different work places. Some trusts are really keen on following NICE guidelines to the T, others are a bit more relaxed about it, and yet others don't seem to care much at all.

In theory, I think all trusts ascribe to NICE guidelines in one way or another, but commissioners may have requested or been offered specific services/therapies in the tendering process (which I think has mixed things up a little?). Either way, there is always some scope for flexibility within the guidelines to allow for person-centred care (e.g. a person for whom treatment XYZ has not been effective should be offered alternatives), so yeah, treatments that don't yet have an established evidence base (or are not yet recommended by NICE) may be offered, depending on demand/supply. That is at least my experience across a few different NHS trusts in London and the south-east of England :)
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maven
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Re: NICE guidelines & service based research in the NHS

Post by maven » Mon Mar 19, 2018 3:29 pm

Yeah, likewise. I think that people acknowledge NICE is what patients should be able to expect (and can use as a yardstick if they want to complain), but it is not always delivered, whilst some non-NICE-endorsed interventions are. The purpose of NICE is to try to recommend best practise, and to encourage services to deliver what has the best evidence, but it often concludes that there are many options, or that the evidence is not clear cut yet. So in my experience I don't think service managers see the guidelines as hard and fast rules.
Maven.

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Golightly
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Joined: Wed Apr 12, 2017 11:08 am

Re: NICE guidelines & service based research in the NHS

Post by Golightly » Mon Mar 19, 2018 10:54 pm

Thanks Mark and Maven for your replies. It's hard to get a sense of what things look like on the ground from policy documents etc and so it's really interesting to hear about the flexibility in services.

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