Transparency data

NICE annual accountability review meeting minutes: 1 November 2023

Updated 19 March 2024

Chair and attendees

The chair was Will Quince, Minister for Health and Secondary Care, Department of Health and Social Care (DHSC).

Attendees:

• Dr Sam Roberts, NICE CEO
• Sharmila Nebhrajani, NICE Chair
• Liz Woodeson, Director, Medicines Directorate
• Kathryn Glover, Deputy Director, Medicines Regulation and Prescribing
• David Lawson, Director of Medical Technology
• David Wright, Head, NICE sponsor team
• Anjali Anicatt, NICE sponsor team
• Rumbidzai Mukwashi, Private secretary, Minister’s office

Welcome and introductions

Minister Quince opened the meeting by thanking Sam and Sharmila for their dedication and hard work over the past year. He noted the role of their leadership in the effective functioning of the National Institute for Health and Care Excellence (NICE) and acknowledged positive feedback from industry about NICE’s work.

Key achievements 2022 to 2023

Sam provided an overview of the transformation NICE is undertaking to improve the relevance and timeliness of its guidance. She explained that in 2022 to 2023, 20 digital or AI-enabled technologies had been assessed by NICE in priority areas such as mental health and weight management.

By adopting a more proportionate approach to technology appraisals, NICE has been able to evaluate medicines 17% faster on average. NICE also launched the first real-world evidence framework in 2022, which is actively being used both by industry and NICE’s committees.

Sharmila explained that NICE has been working closely with NHS England to ensure the NHS is ready to adopt and implement guidance in the context of resource constraints. In relation to MedTech, NICE is working alongside the Medicines and Healthcare products Regulatory Agency (MHRA), NHS England and the devolved administrations to introduce the Innovative Devices Access Pathway (IDAP) to support novel technologies.

Priorities for 2023 to 2024

Sam outlined NICE’s business plan priorities for 2023 to 2024, which seek to build on successes from the past year. These include:

• developing an organisation wide topic prioritisation function to ensure it focuses on what matters most to the health and care system
• improving timeliness for guidance on medicines and MedTech by 15%
• launching a new and simplified website to ensure guidance is more accessible
• integrating its medicines evaluations into clinical guidelines
• tracking implementation of NICE’s guidance through analysis of national data

Sam explained NICE’s new key performance indicator (KPI) for measuring the timeliness of appraisals. She explained the significant difference in time between licensing and final NICE guidance for ‘optimal’ topics when compared to those categorised as ‘divergent’ due to factors outside of NICE’s control. There was agreement that this distinction between topics is extremely useful in informing both industry’s and NICE’s understanding of how performance can be improved. Sharmila noted that the Association of the British Pharmaceutical Industry (ABPI) is pleased with the new KPI and that there is a willingness among parties to play their part in supporting the system. She also noted that this data can be used by system partners to provide market insights and push forward the UK’s life science objectives.

Challenges for 2023 to 2024

A key challenge will be the appropriate sharing of information between NICE and MHRA to ensure timely guidance for newly licensed medicines, especially in the context of international recognition for licensing from January 2024. Sam explained that to prepare for international recognition, NICE has been working with colleagues globally to understand and map out the timelines of other international regulators. They are also working closely with MHRA to make further progress on the sharing of technical information needed for NICE to prepare for appraisals earlier. NICE is also developing surge capacity internally to ensure it can manage a potential rapid increase in products with UK licences.

Another challenge facing NICE and system partners is how to account for and manage the introduction of new medicines with high implementation costs, such as treatments for dementia, COVID-19 and obesity. In some cases, this is due to uncertainty around service delivery models and costs, as well as uncertainty around clinical effectiveness. Sam explained that NICE is working with the manufacturers of these medicines to explore options for the collection of data on their implementation model and the associated costs, for example, through managed access.

Finances

Minister Quince thanked NICE for its engagement with the department’s reform and efficiency programme.

Sam explained that NICE’s income from technology appraisals was forecast to be £1.9 million under plan by year end due to company requests for delays. Through a range of mitigating actions (for example, vacancy panel), NICE has recovered their overall financial position and is now forecasting a £0.4 million surplus by year end.

Following the regulatory review, NICE will receive some additional funding in 2024 to 2025 to support the implementation of horizon scanning and automated scheduling activities. NICE will need to consider other options for generating additional income in 2025 to 2026.