3. NHS PLAN & REFORM (continued)
Clinical guidelines
3. Table 46b provides details of
the clinical guidelines published by NICE since 1 April 2006.
4. NICE only provides estimates of the cost
of implementing the recommendations contained in clinical guidelines
upon publication of the final guidance.
5. NICE assesses the cost of certain key
recommendations within their guidelines i.e. those that are likely
to have the highest costs associated with them, but does not cost
all the recommendations within a guideline.
6. NICE has not provided a cost impact for
all its clinical guidelines published to date. The first detailed
costings were provided for three of the guidelines published in
2004 (fertility; familial breast cancer and lung caner) and since
then NICE has been providing detailed cost information on clinical
guidelines with more regularity. Seven of the nine guidelines
published in 2005 have been costed.
7. There has been no assessment of the actual
cost impact of NICE guidance, due to the inherent logistical difficulties
in measuring the uptake of NICE guidance.
Table 46b
GUIDELINES COSTINGS PUBLISHED TO DATE—COST
OF IMPLEMENTATION
|
| Guideline number | Guideline/Appraisal name
| Date published |
Recommendations with significant resourceimpact
| Net recurrent
implementation
costs (£ thousands)
|
|
| CG11 | Fertility
| Feb 2004 | Increase in provision of IVF services.
| 81,000 |
| CG14 | Familial breast cancer
| June 2004 | Additional annual mamographs and specialist nurse training.
| 2,470 |
| CG23 | Depression in adults
| Dec 2004 | Psychological Interventions
| 54,500 |
| CG24 | Lung cancer
| Feb 2005 | Increases in PET Scanning, chemotherapy and lung cancer nurses.
| 23,248 |
| CG25 | Violence (England)
| May 2005 | Staff training in PCTs andin-patient psychiatric settings.
| 20,019 |
| CG26 | PTSD
| July 2005 | Cost of increase in therapy.
| 25,988 |
| CG28 | Depression in children & young people.
| Oct 2005 | Active psychological intervention.
| 19,466 |
| CG29 | Pressure ulcer management—report produced, but no cost impact estimated.
| Sept 2005 | None identifiable.
| |
| CG30 | LARC
| Dec 2005 | Savings from unplanned pregnancies being avoided.
| -102,258 |
| CG31 | OCD
| Dec 2005 | Cost of adult, young person and child interventions.
| 31,650 |
| CG32 | Nutrition support in adults.
| Feb 2006 | Costs of screening and nurse interventions, offset by reductions in length ofin-patient stays.
| -13,562 |
| CG33 | Tuberculosis.
| Mar 2006 | Additional directly observed therapy for the homeless, problem drug user and prison population—cost of additional staff.
| -3,448 |
| CG34 update | Hypertension
| June-2006 | Pharmacological interventions.
| -221,869 |
| CG35 | Parkinson's disease.
| June-2006 | Regular access to specialist nursing care and access to therapy services.
| 3,777 |
| CG36 | Atrial fibrillation.
| June-2006 | The use of an ECG on all patients in whom a diagnosis of AF is suspected based on the detection of an irregular pulse, the provision of appropriate antithrombotic therapy according to the stroke risk algorithm, and the cost implications arising, such as strokes avoided and haemorrhages incurred, from additional anticoagulation.
| 21,863 |
| CG37 | Postnatal care
| July-2006 | The implementation of an externally evaluated structured programme that encourages breastfeeding. The svings arising from an improvement in breast-feeding.
| -727 |
| CG38 | Bipolar disorder
| July-2006 | The costing work has concentrated on changes in pharmacological prescribing, increases in psychological therapy, introducing an annual review for all people with bipolar disorder and improved access to weight management programs.
| 20,149 |
| Total | |
| | -37,734
|
|
Source: National Institute for Health and Clinical
Excellence (NICE).
|
