NICE is not fulfilling its promise

The National Institute for Clinical Excellence (NICE) does not currently fulfil its promise to give guidance on interventions of uncertain value and provide clinical guidelines and clinical audit packages. This is because there is ambiguity about how NICE reaches its conclusions and uncertainty about the impact of guidance on the NHS and about who monitors compliance. As a result, NICE's impact is uncertain and geographical inequity in the provision of health services is likely to persist. Dent and Sadler (p 842) consider what NICE needs to succeed and how its chances could be improved. They conclude that there needs to be wider debate about criteria, clarity on status, and more concise recommendations about clinical audit methods.