Monday, 16 July 2012

NICE work

Posted by Linda Penn

Just being in that auspicious oak panelled room, breathing history, made me feel delightfully important, although I had done absolutely nothing to warrant the illusion. Then a nice NICE person suggested I might apply. ‘Well’, thought I, ‘no harm in applying, shy bairns etc.’ So I did. And I was eventually enrolled as a member of the NICE Programme Development Group (PDG) for: “Preventing type 2 diabetes: risk identification and interventions for individuals at high risk.” This NICE guidance was published last week, accompanied by a summary in the BMJ.

The National Institute of Health & Clinical Excellence
There is good evidence for prevention of type 2 diabetes, but evidence is not NICE guidance. Guidance may be based on evidence, but there is a huge chasm of reviews, discussion, expert testimony, drafting, comments, more reviews, debate, more comments, economics, considerations, redrafting, more redrafting, consensus and hard work; between literature and guidance. I am full of admiration for the patience and professional endeavour of the NICE team. I do not think I have ever listened so closely, or thought so carefully. ‘Do I have something to say? Is it really worth saying? Am I sure of the point and if so how can I comment in a clear, concise and constructive manner?’ The feeling that ‘This is important, it matters’ never really goes away. The guidance is published. So how did we do?

However good or otherwise, the guidance is one thing. The real importance is in implementation, but that’s a whole different story.

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