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Modern Service Frameworks aim to make high-quality care more consistent across England. Deputy chief medical officer, Judith Richardson explains how NICE guidance is helping turn evidence into practical service improvement.

Every day, practitioners make decisions about patient care based on the evidence and guidance available to them, but that information can come from different evidence sources meaning that the care that follows is not always consistent.

Modern Service Frameworks (MSFs) aim to change that, by bringing the best available evidence together in one place for each priority area, using the evidence base as a backdrop to support service implementation. 

MSFs are a key vehicle for delivering the ambitions of the government's 10 Year Health Plan for England. Each one sets out what good care looks like across an entire pathway or service, bringing together evidence, best practice and system-wide expertise.  

There are 6 priority areas in total: 

1. cardiovascular disease 
2. sepsis 
3. severe mental illness 
4. frailty and dementia 
5. end-of-life care 
6. children and young people. 

For each one, MSFs bring together experts from national bodies, clinicians, commissioners, professional organisations and wider system partners. The goal is to create a shared understanding of what best practice looks like, so that millions of patients across the country will have equal access to the best care, based on the latest evidence.  

This is where NICE comes in. 

Why NICE? 

NICE's role in the MSFs is to bring the latest evidence into the service design, making sure each framework is built on the strongest foundation possible. NICE guidance underpin the frameworks, helping to identify were further implementation, new or updated guidance may be needed. 

For NICE, MSFs represent something important: evidence that our guidance doesn't just sit on a shelf. When an MSF is built on our guidance and quality standards, it means our recommendations are actively shaping how the NHS organises and delivers care for millions of people. 

But it's not a one-way process. MSFs give organisations the chance to work together around a shared goal, improving outcomes for patients, and that collaboration helps NICE prioritise its own work too, whether that's updating existing guidance or developing something entirely new. 

No 2 frameworks are the same, so NICE's contribution varies depending on the topic and the outcomes needed. Sometimes that means embedding existing guidance. Sometimes it means spotting gaps in the evidence. Sometimes it means scoping out priorities for the future. NICE responds to what each framework needs, not a fixed template. 

Where things stand today

All 6 frameworks are due to be published this year, and 2 are already out. The cardiovascular disease and sepsis frameworks were published last month, marking the programme's first milestones.  

Both frameworks embed key themes from the 10 Year Health Plan: moving care to community settings, expanding the use of digital tools and focusing on preventative care. 

The cardiovascular disease framework describes a long-term vision for how prevention, diagnosis and treatment will evolve. It's also grown in scope to include kidney and metabolic disease, reflecting the reality that these conditions are often closely linked.  

In the sepsis framework, NICE guidance is helping underpin the delivery model. Recommendations on recognition, diagnosis and treatment form a key part of the clinical approach being developed nationally. 

Neither of these came out of nowhere. Earlier this year, NICE's prioritisation work aligned closely to national priorities and the 10 Year Health Plan. Both cardiovascular disease and sepsis were highlighted as priority topics in our Forward View, giving partners early visibility of guidance already in development, and guidance still to come. 

The remaining 4 frameworks, covering severe mental illness, frailty and dementia, end-of-life care, and children and young people, are currently in development. NICE is already working alongside partners on each one, and that work will keep being shaped by what each framework specifically needs. As each area develops, our guidance will keep pace with it. 

Continuing the collaboration

MSFs represent an opportunity to strengthen the connection between evidence and implementation. As the remaining frameworks are developed and published over the coming months, NICE will keep working with partners to make sure each one is grounded in the best available evidence, whatever form that contribution needs to take. 

We're proud to be part of this collaborative programme, and we'll keep working closely with partners as more frameworks take shape.