A to Z of MS National Institute for Health and Care Excellence (NICE)

NICE is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health in England and Wales.

NICE was established as the National Institute for Clinical Excellence in 1999, partly to ensure equity of care and medicines prescribing across the NHS in England and Wales.

In April 2005, NICE was combined with the Health Development Agency to create a single organisation for the promotion of good health as well as the prevention and treatment of ill health. The name was changed to the National Institute for Health and Clinical Excellence.

In March 2013, the remit of NICE was extended to include social care services and the name changed to the National Institute for Health and Care Excellence.

What NICE does

NICE provides three types of clinical guidance:

• Technology appraisals - guidance on the use of new and existing medicines and treatments within the NHS in England and Wales. These appraisals determine whether it is cost effective for licensed treatments to be made available on the NHS.
• Clinical guidelines - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS in England and Wales.
• Interventional procedures - guidance on whether interventional procedures used for diagnosis or treatment are safe enough and work well enough for routine use. Interventional procedures covers internal examinations using surgery or other invasive methods and treatments using lasers or radiation, such as x-rays.

Technology appraisal guidance issued for MS includes that given on the beta interferon drugs and glatiramer acetate in 2002, natalizumab (Tysabri) in 2007 and fingolimod (Gilenya) in 2012. It has also issued guidance on percutaneous venoplasty as a treatment for CCSVI.

It is probable that other new drug therapies will also be subject to NICE appraisal when a licence is granted.

NICE has also produced National Clinical Guidelines For the Management of Multiple Sclerosis in Primary and Secondary Care in the National Health Service. Originally published in 2003, NICE began the process of reviewing the Guideline in 2011.

NICE website

Scotland

In Scotland the role of NICE is split between the Scottish Medicines Consortium (SMC), which appraises new and existing medicines and treatments, and the Scottish Intercollegiate Guidelines Network (SIGN), part of NHS Quality Improvement Scotland, which produces clinical guidelines in aspects of healthcare.

SMC website

SIGN website

Northern Ireland

Responsibility for health issues lies with the Department of Health, Social Services and Public Safety

Department of Health, Social Services and Public Safety website

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