WIREDGOV

There are millions of acts of kindness going on within the NHS and social care services, says the Chair of NICE.

Speaking at the NICE Annual Conference in Liverpool, Professor Haslam said that the reason the NHS is so cherished is that it delivers the services people demand and as a result people's trust is earned. 

"Kindness and trust.  They are hugely important words because – for me – they sum up the relationships that we each have with the people who work in the NHS and in social care. The words imply a relationship between people. They imply care, community, friendship.

"At this moment in the NHS or in social care services, there are millions of acts of kindness.

"Somewhere, a nurse is returning home from a night shift where she comforted a small and bewildered child with cancer.

"Another nurse is holding the hand of a shell-shocked mother who has delivered a very small and sick baby 13 weeks early.

"A paramedic is talking quietly to an elderly man collapsed on his kitchen floor.

"A homecare worker is listening to a pensioner’s fears for her independence.

"A GP is reassuring a pregnant woman desperate to stop smoking.

"A porter shares a joke with a man with a cancerous thyroid as he pushes him to theatre.

"The list goes on. And on: not thousands of acts of kindness, not tens of thousands but millions each day, every day. These are our social care services, our NHS."

So what should we do to maintain trust?

Professor Haslam said that it is important that the NHS and social care services continue to maintain public trust, and this is where NICE fits in.

"To produce our guidance, the best evidence on a topic is gathered and assessed, an independent committee of experts discusses the data, hears from other experts – including patients and service users – deliberates over the topic in hand and reaches a consensus view on their recommendations. At this point, we seek views on the draft through consultation, then the committee agrees the final guidance.

"But to maintain trust, we have to make sure that we continue to provide the best service to people.  We must strive to improve. There are real challenges in this. Not least because of constrained budgets.

"Patients are facing different problems: Long-term health conditions – rather than easily curable illnesses – take 70 per cent of the health service budget.

"At the same time many people want to be more informed and involved with their own care. They want to be supported as they strive to live healthier lives and in making decisions about the medicines they take. 

"This is one of the challenges identified in the NHS’ 5 year forward view.

"It also says the country is “too diverse for a ‘one size fits all’ care model to apply everywhere”. This is another challenge where NICE will have a key role: local answers to challenges in delivering healthcare must be supported with the best available evidence and knowledge to ensure that unacceptable variations in care are eradicated or prevented from developing.

"And tapping into the resources offered by NICE can bring real financial benefits. We are currently working to flag better how people can use NICE guidance to save money and improve care.

"So NICE guidelines give a population-level steer on what the most clinically and cost effective ways are to treat different diseases and conditions. Nationally, the guidance helps the NHS make sure that it’s getting the best value for taxpayers’ money.

"But it is essential to remember that on an individual level, our recommendations might not always be appropriate for individual patients. The guidance is not intended to replace a doctor’s clinical judgement or the joint decisions they make with their patients about their specific and individual needs.

"Our job at NICE is to ensure clinicians and social care professionals are supported to give the very best care to people. Equally we understand that each discussion between a patient and their clinicians is unique. 

"NICE guidance is a gold-standard which professionals should take very seriously. But the role of the clinician is to interpret our guidance together with their training and experience in the interests of the patient before them." 

Office for Market Access 

One of NICE’s jobs is to work out the clinical and cost-effectiveness of drugs and treatments to ensure the NHS in England gets value for the money it spends and patients get the best possible treatments.

NICE also has an important role in creating the environment in which the faster development and delivery of new, effective, innovative and affordable drugs to patients is encouraged and enabled. The launch of a new Office for Market Access will play a key role in this. 

"We think the Office for Market Access – or OMA – will help in minimising the risk for companies, and improve the rates at which drugs get picked up and adopted by the NHS," said Professor Halsam.

"OMA will speed up the adoption of innovative, cost-effective health technologies. Of course, consulting OMA will not guarantee a positive appraisal but it will be extremely helpful to companies in gathering the right evidence, developing a better business case and engaging with the right people.

"OMA will sit alongside the important work being done as part of the government’s Accelerated Access Review under the leadership of the minister for Life Sciences George Freeman. This review is intended to help clear a path through the regulatory landscape for new technologies to get to patients quicker.

"NICE has a role to play, not only enabling the NHS to be a world-leader in the efficient adoption of new technologies, but also in fostering innovation and growth in the UK’s life science industries."

The challege of multimorbidities

Professor Haslam warned that since the NHS’ founding nearly seventy years ago, the world has changed beyond recognition, and health and social care services now need to face up to very different challenges. 

"We live longer. Now we often live with complex health issues as we age, many of them caused by the way we live:

• One in five adults smokes.
• A third of us drink too much alcohol.
• Just under two thirds of us are overweight or obese.
• We are not active enough and our diets are laden with sugar, salt and fat.

"So living longer does not stop the ageing process. Many of us as we get older will be treated for hypertension as our blood vessels and heart muscle begin to stiffen, our bones become weaker – leading to osteoarthritis, we can struggle to eat because of difficulty swallowing and tooth loss, we suffer memory problems, develop dementia, diabetes, cataracts, need joint transplants. 

"People working in the frontline of health and social care often see patients with several of these diseases of ageing. And this multimorbidity is not confined to the old – it is prevalent among younger people who eat too much, exercise too little, have poor diets, drink too much and smoke. They may also have depression.

"Next year NICE will publish a clinical guideline that considers the assessment and management of multimorbidity. As a GP, I consider this issue to be hugely important for the NHS and the people whose lives it seeks to improve.

"Effective management of obesity, lipid levels and blood pressure, as well as helping people to stop smoking, drink less or become more active, can make a very real difference to preventing heart disease and stroke.

"So we can help people live longer, with less disability."