I have often turned to guidelines from the National Institute for Health and Care Excellence, accepting it as the “oracle” of guidance for evidence-based best practice in relation to care.
As the first NICE social care fellow from the care home sector, I have found it an enlightening experience. I have also worked with NICE as a co-opted member of a quality standard and a public health topic guidance group, which gave me the opportunity to help shape NICE guidance, ensuring it is informed by current practice in the care home sector and can be translated into practice.
In my experience, nursing input to NICE guidance is valued and can provide a much-needed pragmatic voice and reality check among the mix of academics, economists, analysts, members of the public and expert clinicians. However, it is not for the faint hearted - the whole process of guidance development is very much a marathon as opposed to a sprint.
Fellowship opportunities are posted on NICE’s website each autumn, with up to 10 fellowships awarded each year. This year’s application period runs until 13 November. NICE fellowships last three years, during which members meet regularly with the other fellows and/or NICE scholars for study days and to attend the two-day annual NICE conference. Fellows also have access to the ongoing support of a NICE mentor, together with the wider fellows and scholars team. In return, fellows are expected to act as an ambassador for NICE.
Recruitment to NICE guidance groups is similarly carried out via the NICE website. These are unpaid roles requiring a lengthy time commitment and dedication to the task in hand.
Meetings are usually held at the NICE offices in Manchester and may require an overnight stay. Typically, groups meet for 10 days over nine months. During this time, background papers, literature reviews and economic analyses are circulated for review as part of the iterative process.
In my experience, the person chairing the group has been crucial to its effectiveness. With as many as 20 passionate voices around one table, their organisational skills are tested to ensure expertise, experience, personal interests, passion and reality are all given equal voice.
The limited evidence base, particularly for social care interventions, can make the NICE process of basing guidance on sound rigorous evidence particularly challenging. The NICE guideline development process only uses validated assessment tools, some of which may not have been validated in a social care setting or for the specific population group at which the guidance is aimed. Also, from a social care perspective, validated assessment tools may be difficult to use, as language and terminology may be unfamiliar to frontline social care staff. NICE works closely with partners from the social care sector to ensure guidance reflects the needs of frontline social care staff and has produced tailored resources to help them put guidance into practice.
I wholly encourage nurses to access opportunities to work with NICE. Your contribution to the guidance and standards groups can directly influence national guidelines that will be used across the NHS and social care, and inform research. Additionally, guidance may be adopted by other countries.
The uniting feeling among NICE groups, irrespective of their area of practice or specialism, has been that pursuing pathways of excellence in the face of austerity is incredibly challenging. It is commendable that NICE continues to give practitioners the chance to get involved in shaping national guidance and policy.
Victoria Elliot is a principal care consultant (research and innovation) at The Orders of St John Care Trust