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NICE Implementation Collaborative (NIC)

The NIC is a unique partnership between the NHS, Life Sciences industry, Healthcare professional bodies, key health organisations and Patient groups. NIC partners are committed to working together to support a system where patients have faster and more consistent access to NICE-recommended medicines, treatments and technologies and is a collaboration which completely re-draws the landscape. Industry will now work with academia, clinical groups, NHS England, NICE and representative bodies to drive compliance with NICE recommendations.

The partnership underpinned by the signing of a concordat in March 2013. The Concordat is made up of the following members:

  • Academy of Medical Royal Colleges
  • Association of British Healthcare Industries (ABHI)
  • Foundation Trust Network
  • NHS Alliance NHS
  • Commissioning Assembly
  • NHS Confederation
  • NHS England
  • National Institute for Health and Care Excellence (NICE)
  • Patients Involved in NICE
  • Royal Pharmaceutical Society
  • The Academy of Medical Sciences
  • The Association of the British Pharmaceutical Industry (ABPI)
  • The British In Vitro Diagnostics Association (BIVDA)

What does the NIC do?

  1. Identify practical measures that support and promote timely and consistent implementation of NICE Technology Appraisals throughout the NHS in England
  2. Work jointly to support and promote the adoption of all other forms of NICE guidance that apply to the NHS in England, and to drive the uptake of innovation, in a way that is consistent with local health needs and priorities
  3. Understand the barriers that restrict expected levels of implementation and uptake, including the requirement for CCGs to provide care for their populations taking into account local affordability and clinical need. The NIC will identify practical measures that its members and all organisations providing NHS services to patients can take to help overcome these barriers
  4. Support a culture shift within the NHS in favour of clinically- and cost-effective innovation


Small arrow Latest NIC work streams

Nalmefene (NICETA 325)

Nalmefene (NICE TA 325) for reducing alcohol consumption in people with alcohol dependance. The NIC currently has a work stream looking at the implementation...

Non-ST-Elevation Acute Coronary Syndromes

Improving NSTEACS patient outcomes and experience. The 2013 Cardiovascular Outcomes Strategy report highlighted that there is scope for improvement in the...
Small arrow Recent NIC work streams

BNP testing in heart failure (CG108)

Around 900,000 people in the UK have heart failure. Almost as many have damaged hearts but, as yet, no symptoms of heart failure. Both the incidence and prevalence of heart failure increase steeply with age, with the average age at first diagnosis being 76 years.

The prevalence of heart failure is expected to rise in future as a result of an ageing population,improved survival of people with ischaemic heart disease and more effective treatments for heart failure Testing for serum natriuretic peptides (B-type natriuretic peptide BNP or N-terminal pro-Btype natriuretic peptide NTproBNP) in patients with suspected heart failure without previous myocardial infarction can accelerate diagnosis of heart failure and also avoid unnecessary echocardiography. NICE Clinical Guidance 108, and in particular natriuretic peptide testing, was selected as a NIC pilot given the evidence of inconsistent adoption across the NHS and also due to the complexities involved in redesigning patient pathways to accommodate technologies such as these and improve patient outcomes.

What are the barriers to uptake of NICE guidance?

The NIC has worked with the system to better understand the barriers that exist to more consistent adoption of natriuretic peptide testing in diagnosing chronic heart failure. These include:

  • Cost impact uncertainties. While savings will be made via the reduction in echocardiograms funding for the tests will be required by the NHS pathology departments
  • Long term savings are often not prioritised over ‘in year’ spend. It can be difficult to get commissioners and providers to see the value of a diagnostic which can create long term savings
  • Complexity of (partial) decommissioning of services within the NHS
  • Failure to communicate heart failure strategy throughout the NHS

How will the NIC support the system?

As part of its pilot work, the NIC is committed to identifying solutions and recommending practical steps that will overcome the barriers to adoption. As well as recommending specific steps that will improve patient outcomes through more the use of natriuretic peptide testing the pilots also will help the NIC understand how it can best support innovation in the system while respecting clinical autonomy and local commissioning decisions. The NIC has established a pilot advisory board that will help it develop and test solutions that will deliver the maximum benefit to patients across the system. The NIC is looking at solutions that include:

  • Ensure that a known individual is accountable for the implementation of CG108 in each Clinical Commissioning Group
  • Ensure that that individual is trained and aware of the business economics and patient outcome benefits of early diagnosis of heart failure enabled by CG108
  • Develop a template communication package targeted at general practitioners, for use by CCG accountable individual
  • Define a reporting mechanism to enable CCG to track usage in individual practitioners
  • Input to discussion of ‘aligning financial incentives’ to reward adoption

The NIC is also committed to measuring the success of the solutions it develops to establish how it can best support the system to improve patient outcomes.

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Small arrow Relevant NIC documents

Innovation Scorecard - Challenging Variation Report

Many of the medicines and medical technologies reviewed by the NIC are included in the quarterly Innovation Scorecard publication. The NHS England Innovation team produce a quarterly summary...

NICE Implementation Collaborative Concordat

Click here to download a copy of the NICE Implementation Collaborative Concordat which was signed by NIC partners in 2013.

Getting cost effective technologies into practice

This draft report produced for the NIC looks at a framework to assess the value to the NHS of investing in the implementation of NICE technologies. The report looks how the model could be applied...

Other relevant initiatives 

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Road map link

Innovation Compass link