A NICE recap of a challenging year

Professor David Haslam, Chair of NICE

The legacy of 2016 has made its mark - from the shock result of the American elections and the impact of Brexit, to the departures of Bowie, Cohen and others. In this context, our day-to-day work can seem to pale into insignificance. Except, when you’re in general practice, this isn’t quite true.

As GPs, over and over again you see patients whose lives are turned upside down by the development of new symptoms, the impact of diagnoses and the fear of the unknown. The extraordinary complexity of the generalist’s work is remarkably challenging, and not helped by the seemingly ceaseless impact of change - whether clinical, organisational, or political.

NICE aims to be a source of support and guidance for GPs. I know it doesn’t always feel that way, when you’re faced with yet more advice or evidence, but as I pointed out in my keynote address at RCGP’s annual conference (which was one of the real highlights of my year), if NICE didn’t exist, either you would have to read all the new research and evidence yourself, or rely on someone else to do it. So my very clear aim is for NICE to be seen as a resource – a genuine resource – for GPs and everyone who works in primary care.

Over the past year at NICE, we’ve produced a wide range of important new guidelines and standards, and many of these cover the conditions and diseases GPs deal with day in, day out. In September we published our long awaited guideline on multimorbidity, which sets out how we should put patients with complex health issues at the heart of decisions about their care, including how to decide between different medicines and treatments. We also produced guidance on: sepsis; non-alcoholic fatty liver disease; cirrhosis; and end of life care for infants, children and young people, as well as quality standards on: diabetes in children and young people; diabetes in pregnancy; suspected cancer; antenatal and postnatal mental health; and obesity in adults.

As a generalist, it will come as no surprise that so much of what NICE produces is relevant to you and the patients you treat, more so than for many other clinicians. This is why it’s crucial for us at NICE to involve GPs in our work from scoping topics through to producing final guidance and standards. We learn so much from the feedback and expertise GPs provide. Your input really does make a difference.

Every year, GPs play a key role in helping NICE produce guidance that works in practice. One example from 2016 that really stands out for me, is the vital input GPs have had into our draft guidance on asthma diagnosis and monitoring. The GP community raised concerns about the practicality of implementing this guidance in primary care, and so we halted publication and began work on a new project to test the recommendations in question. The support from GPs and their practice teams to get involved in this project has been outstanding. Seven primary care sites across England, which use different asthma service delivery models, were recruited to the project and their findings will be considered before the guidance publishes in summer 2017.

And as for NICE ourselves, 2016 has presented plenty of challenges for us too. Like the rest of the NHS and the Arm’s Length Bodies, we have faced dramatic funding cuts, whilst demand for our products continues to grow. Brexit itself also impacted, with concerns about how this might affect regulation and impact on the life science industries.

On a personal level, 2016 has provided many opportunities for me to speak to numerous students and doctors in the early phase of their careers. I’ve found that medical students in particular often express surprise that a GP is doing a job like mine. And I always gently point out that their surprise is evidence of their own prejudices, and that general practice is without a doubt the most fascinating, complex and broad medical specialty of them all.

Undeniably, next year we will all face yet more change. That’s the nature of things, especially in healthcare. 2017 won’t be dull, and I have every confidence that the GP community is absolutely up for every challenge that comes its way. May I wish you all the very best for the year ahead.

Note: To see what guidance and standards NICE has planned for 2017, go to the NICE website.


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