Download NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE

Guidance
British National Formulary Publications
producer:
Guidance
British National Formulary, British
product:
National Formulary for Children
Date:
29 August 2013
Version:
1.4
Accreditation Decision Report – for consultation
British National Formulary Publications: British National Formulary, British National Formulary for
Children: Accreditation Report for consultation
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Contents
Introduction ..................................................................................................................... 3
Accreditation recommendation ........................................................................................ 3
Reapplication for accreditation ........................................................................................ 6
Appendix A: NICE Accreditation analysis ........................................................................ 7
Appendix B: Bibliography .............................................................................................. 20
Appendix C: NICE Accreditation Advisory Committee, external advisers and NICE
Accreditation team......................................................................................................... 27
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Introduction
The NICE Accreditation Programme recognises organisations that demonstrate high
standards in producing health or social care guidance. Users of the accredited guidance
may therefore have high confidence in the quality of the information. Organisations can
publicly display a seal of approval called an Accreditation Mark for 5 years after their
processes have been accredited. The process for accrediting producers of guidance
and recommendations for practice is described in the process manual.
Accreditation recommendation
It is proposed that the process used by British National Formulary Publications to
produce the British National Formulary and British National Formulary for Children
is not recommended for accreditation. This decision is subject to public consultation
before a final decision is made.
Background to the guidance producer
The British National Formulary (BNF) is published by the British Medical Association
(BMA) and the Royal Pharmaceutical Society (RPS), through the British Medical Journal
(BMJ) Group and the Pharmaceutical Press. The British National Formulary for Children
(BNFC) is published by the RPS, BMA, Royal College of Paediatrics and Child Health
(RCPCH) and the Neonatal and Paediatric Pharmacist Group (NPPG). BNF
Publications is a consortium of these organisations. Funding for the guidance is
provided by the health services of the 4 home countries of the UK, and the contract is
managed by NICE. BNF Publications also produce the Nurse Prescribers’ Formulary
(NPF) which is a developed from a sub-set of the information in the BNF and BNFC.
The process used to produce the NPF is the subject of a separate decision due to some
key differences in the process, which are explained in that decision report.
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The BNF and BNFC aim to provide prescribers, pharmacists and other healthcare
professionals with accurate and up-to-date information about the use of medicines,
including key information on selection, prescribing, dispensing and administration. This
includes categorical information specific to individual medicines (termed ‘medicines
information’ in this report), and more general information about conditions, classes of
medicines and when it is appropriate to use them (termed ‘clinical information’ in this
report). This information is advice designed to guide the decision making of prescribers,
and is developed according to a standard process which can be assessed using the
accreditation criteria.
Summary
The Accreditation Advisory Committee considered that the processes used by BNF
Publications to produce the BNF and BNFC demonstrated compliance with 18 of the 25
criteria for accreditation, with 6 criteria not fully met, and 1 criterion not met.
Overall the scope and purpose of the BNFC and BNFC are clear. The publications are
based on a systematic search for evidence that takes into account the risks, benefits
and side effects of different treatment options. The advice is presented clearly and a
variety of support tools are available to aid implementation.
Whilst the process has strengths, there are concerns about the lack of stakeholder
involvement for some groups and the lack of a process for systematically assessing the
strengths, weaknesses and areas of uncertainty in the evidence and communicating
them to the end user. It is not clear that the process for peer review is external and the
lack of involvement of particular groups of stakeholders may affect the suitability of the
content for some users. In addition, the end user cannot tell when different sections
were last updated or reviewed and the prices of medicines have not been updated since
2011.
The assessment identified several areas where processes fall short of the required
standard. The main improvement that must be made is:
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to develop and implement a robust process to systematically and transparently
assess the strengths, weaknesses and areas of uncertainty in the evidence base
and communicate them to the end user.
Further recommendations for improvement of the process include:
continuing with the recruitment of lay members to the formulary committees and
ensuring lay participation is meaningful
involving all relevant stakeholder groups and target users including Community
Practitioners and Nurse Prescribers in developing recommendations
ensuring external peer review of the recommendations
updating the prices of medicines in the publications
ensuring the end user knows when each section was last updated or reviewed
ensuring the content, format and language is appropriate for all target users
This draft decision is now going out for consultation, and the decision will be reviewed
by the committee in the light of any feedback received before making a final
recommendation.
Professor Martin Underwood
Chair, Advisory Committee
August 2013
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Reapplication for accreditation
Following a final decision in which accreditation has not been granted, guidance from
the non-accredited producer will still be available on the NICE Evidence site but will not
be identified by the accreditation mark graphic.
Guidance producers that have not been awarded accreditation may reapply from 1 year
after the previous assessment. The organisation should address any concerns
highlighted in the original assessment before reapplying. The NICE Accreditation team
will provide detailed feedback and advice on areas in which improvement is needed to
meet the criteria in a future application.
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Appendix A: NICE Accreditation analysis
The Advisory Committee considered the following analysis of the guidance producer’s compliance with NICE Accreditation
criteria, which covers 6 discrete domains. The full analysis leading to the accreditation decision is shown below.
Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
Does the guidance producer have a policy in place and adhered to that requires them to explicitly detail:
1.1
Overall objective
1
2
The BNF and BNFC are produced according to a standard format
3,4,5
.
Criterion met
The aims of the publications are stated in prefaces and on the rear covers
1,2
of the publications .
1
Scope and
purpose
1.2
The clinical, healthcare or
social questions covered
2
The BNF and BNFC aim to address high-level questions of drug safety,
Criterion met
effectiveness, appropriateness, dosage and adverse effects for all
medications covered. Information relating to these key questions such as
cautions, contraindications and side effects is provided in a standard
3,4,5
format
for each medicine or class of medicine. Clinical questions
outside the medicines information are answered through the clinical
information found at the start of each chapter and section. This can be
1
2
seen in the BNF and BNFC .
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
1.3
Population and/or target
audience to whom the
guidance applies
The target audiences for BNF and BNFC are detailed on the rear
Criterion met
1,2
covers . The overall target population is broad given the variety of
medicines covered, but specific populations are defined by the indications
1,2
for each medicine .
1.4
Guidance includes clear
recommendations in
reference to specific
clinical, healthcare or
social circumstances
The standard format
3,4,5
1
2
of the BNF and BNFC and help to ensure
Criterion met
recommendations are given in reference to specific clinical or healthcare
circumstances. Guidance is provided for individual medicines to treat
specified conditions including indications, contraindications and
1,2
cautions , which cover the clinical circumstances in which a medicine is
recommended or not.
Does the guidance producer have a policy in place and adhered to that means it includes:
2.1
Stakeholder
involvement
Individuals from all
relevant stakeholder
groups, including patient
groups, in developing
guidance
The document ‘Standing Orders of the Formulary Committees of the
Not fully met
6
British National Formulary’ details the composition of the Joint Formulary
Committee (JFC) and the Paediatric Formulary Committee (PFC). The
committees include pharmacists and clinical representatives from a
number of stakeholder groups, but do not include nurse prescribers for
example, who are also an audience for the publications as they are
8
expected to refer to them when using the NPF . The publications
1,2
detail
the membership of the committees and the contributing expert advisers.
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
1
2.2
Patient and service user
representatives and
seeks patient views and
preferences in developing
guidance
2
Some sources of evidence that the BNF and BNFC involve patients in
Not fully met
the development of their guidance, as described in ‘Standard reference
7
sources’ . Patients are also involved in the development of cautionary and
1
2
advisory warnings provided as appendix 3 of the BNF and BNFC . There
6
are no lay or patient representatives on the JFC or PFC however , so
some recommendations are developed without lay or patient input. The
guidance producer has stated that recruitment of lay members to the JFC
and PFC is underway, but lay members are not currently in place.
2.3
Representative intended
users in developing
guidance.
The document ‘Standing Orders of the Formulary Committees of the
Not fully met
6
British National Formulary’ details the composition of the JFC and the
PFC. The committees include target users such as pharmacists and
8
doctors, but do not include users of the NPF who are also expected to
refer to the publications. The publications
1,2
detail the membership of the
committees and the contributing expert advisers.
Rigour of
Does the guidance producer have a clear policy in place that:
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
development
3.1
Requires the guidance
producer to use
systematic methods to
search for evidence and
provide details of the
search strategy
7
9
‘Standard reference sources’ and ‘Journal allocation list’ provide lists of
Criterion met
key sources of evidence which are scanned regularly for new medicines
and clinical information. This includes updated summaries of product
characteristics (SPC), drug safety updates (DSU), guidelines and journals.
NICE also regularly notifies the guidance producer of any new relevant
evidence it produces. This process is another systematic route to identify
new evidence. Evidence of regular scanning of sources is provided by an
10
internal tracking spreadsheet .
3.2
Requires the guidance
producers to state the
criteria and reasons for
inclusion or exclusion of
evidence identified by the
evidence review
High level inclusion and exclusion criteria are detailed in the document
Criterion met
‘Criteria for inclusion and exclusion of products in BNF and BNF for
11
Children’ . Evidence about all prescription-only medicines licensed for
use in the UK is included. ‘Specials’ (unlicensed medicinal products for
individual patients) are excluded. There are additional inclusion criteria
covering certain non-prescription medicines, and devices that may be
1
prescribed for use with medicines. The section of the BNF and BNFC
2
‘How the BNF is constructed’ provides information on some of the
inclusion criteria for evidence based upon the type and source of
information.
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
3.3
Describes the strengths
and limitations of the
body of evidence and
acknowledges any areas
of uncertainty
Medicines information that comes explicitly and exclusively from SPCs is
Not met.
authoritative and reliable, however many other sources of evidence are
1
2
included in the development of the BNF and BNFC , so it is vital there is
an appropriate process to appraise such evidence. The document
7
‘Standard reference sources’ ranks sources of evidence according to how
accurate and reliable the guidance producer considers the information
from those sources to be, but there is no systematic process to appraise
individual items of evidence from those sources. Ranks include large
groups such as journals, and evidence from sources within the same rank
appears to be considered of equivalent quality. The transcripts
12
of
discussions by expert advisers, the JFC and PFC do not demonstrate
systematic consideration of the strengths and weaknesses of the
evidence. There is no process for communicating the strengths,
weaknesses and areas of uncertainty in the evidence base to the end
user. The publications indicate where medicines information deviates from
an SPC and in some cases where clinical information comes from a
specific guideline producer, but the strength of the information provided is
unknown.
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
3.4
Describes the method
used to arrive at
recommendations (for
example, a voting system
or formal consensus
techniques like Delphi
consensus)
The process
13
states that content changes based on updated SPC or
Criterion met
DSUs are made by the editorial team. Any other evidence is first
examined by the editorial team, then expert advisers who are practising
clinicians, then the JFC or PFC. The document ‘Standing orders of the
6
formulary committees of the British National Formulary’ explains that
consensus is used to reach decisions. Where consensus is not possible a
voting system is used. Transcripts of conversations demonstrate this
12
process in action .
3.5
Requires the guidance
producers to consider the
health benefits against
the side effects and risks
in formulating
recommendations
1
2
The BNF and BNFC present medicines information in a standard
3,4,5
format
Criterion met
that details contraindications and side effects. The clinical
information also discusses the risks and side effects of classes of
medicines for different conditions. Any amendments to this information,
unless directly derived from SPCs or DSUs, requires discussion by the
13
JFC or PFC following input from external advisers . The transcripts of
these discussions
12
show consideration of the risks, benefits and side
effects in reaching recommendations for both medicines and clinical
information.
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
3.6
Describes the processes
of external peer review
Recommendations from the JFC and PFC are reviewed by editors who
Not fully met
work for BNF Publications with no prior involvement in assessing the
evidence or developing the recommendations. A screenshot of an internal
content change tracker
14
provides evidence of this process. It is not clear
however that there is sufficient separation between different members of
the editorial team for this to represent a process of external peer review.
Expert advisers review entire chapters of the publications but this occurs
post-publication and it is not stated that those advisers should not have
had prior involvement in developing the recommendations.
3.7
Describes the process of
updating guidance and
maintaining and
improving guidance
quality
1
2
The BNF and BNFC are produced every 6 months in hard copy and are
Not fully met
15
updated monthly online . The process states that medicines information
is reviewed at least every 3 years, or sooner if new evidence becomes
13
available . Clinical information is updated when new evidence becomes
available through the systematic scanning of evidence sources. The BNF
1
2
and BNFC clearly state how often they are updated in hard copy and
online, but it is not clear to the end user when each section was last
updated or reviewed. The prices of medicines have not been updated
since 2011 due to an on-going change in process.
Clarity and
Does the guidance producer ensure that:
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
presentation
4.1
Recommendations are
specific, unambiguous
and clearly identifiable
The format of information in the BNF and BNFC is governed by a number
of style guides
3,4,5
Criterion met
which ensure the advice is clearly presented.
1
2
Examination of the BNF and BNFC show that the recommendations are
specific, unambiguous and clearly identifiable.
4.2
4.3
3,4,5
1
2
Different options for the
management of the
condition or options for
intervention are clearly
presented
The standard format
of the BNF and BNFC ensures a range of
The date of search, the
date of publication or last
update and the proposed
date for review are clearly
stated
The BNF and BNFC are printed publications with a copyright statement
Criterion met
medicines are presented where available, allowing the prescriber to the
1
2
most appropriate medicine. Examination of the BNF and BNFC shows
that the options for management or intervention are clearly presented.
1
2
Criterion met
on the first page containing the year of publication. The BNF displays the
1
month and the year of publication on the front cover . The updating
frequency for each publication is stated both in the process
13
and in the
12
publications . This also informs users of the period of new evidence taken
into account in the new edition compared to the previous edition (6
months for the BNF, 1 year for the BNFC, and monthly for the BNF and
BNFC online). This is an appropriate alternative to a single date of search
as the publication relies on regular searching of many evidence sources.
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
4.4
The content of the
guidance is suitable for
the specified target
audience. If patients or
service users are part of
this audience, the
language should be
appropriate.
The process
13
6
includes multidisciplinary committees to help ensure the
Not fully met
content is suitable for the target audience, but some sections of the target
audience are not represented, for example community practitioner nurse
prescribers. Therefore there are some gaps in the process for ensuring
the content is suitable for the target audience.
Does the guidance producer routinely consider:
5.1
Applicability
Publishing support tools
to aid implementation of
guidance
1
2
The BNF and BNFC are designed as succinct reference tools. They
Criterion met
include guidance on how to write prescriptions, prescribing for particular
groups, and details of major changes since the last edition. Online
versions of the BNF and BNFC are available
15
to subscribers or those with
an NHS Athens account that contain recent updates and provide a quick
way to find medicines information. The BNF is also available as an
application for smart-phones
16
which may assist prescribers who do not
have access to a hard copy whilst working.
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
5.2
Discussion of potential
organisational and
financial barriers in
applying its
recommendations
1
2
Both the BNF and the BNFC contain the section ‘Taking medicines to
Criterion met
best effect’ that provides advice for prescribers in overcoming barriers to
adherence of a medicines regimen. The section ‘Controlled drugs and
drug dependence’ explain the organisational and legislative barriers to
prescribing controlled drugs along with the requirements for prescriptions.
Positive or negative NICE technology appraisals are indicated in the
1,2
guidance , which may indicate to prescribers that NHS funding might not
be available for certain drugs.
5.3
That their guidance is
current, with review
criteria for monitoring
and/or audit purposes
within each product.
There are processes to monitor usage of the BNF through market
17
1
Criterion met
2
research activities . The BNF and BNFC all contain MHRA ‘yellow
cards’ for reporting suspected adverse reactions to medicines. This
demonstrates a form of monitoring included within the guidance product
as yellow cards are important for monitoring medicines in the marketplace.
Editorial
Does the guidance producer:
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
independence
6.1
Ensure editorial
independence from the
funding body
The health services of the 4 home countries of the UK are the funding
Criterion met
source, but it would be impossible to ensure adequate professional
stakeholder involvement without including a variety of health service
1
employees in development of the BNF . In practice the NHS employees
who sit on the committees are not responsible for purchasing the BNF.
BNF Publications is also independent of the pharmaceutical industry and
receives no funding from them. The publications do not include adverts for
any products. All committee members and external advisers are required
to declare any conflicts of interest
6.2
Demonstrate
transparency about the
funding mechanisms for
its guidance
1
6,20
.
2
The funding source for the BNF and BNFC are the health services of the
Criterion met
4 home countries of the UK, and the contract is managed by NICE. The
BNF and BNFC include a statement that they are funded by sales to the
1,2
health service .
6.3
Record and state any
potential conflicts of
interest of individuals
involved in developing
the recommendations
6
The standing orders of the formulary committees , terms of reference for
expert advisers
18
and declaration of interests form for expert advisers
Criterion met
20
provide comprehensive, appropriate policies for declaring and managing a
range of conflicts of interest. BNF editorial staff are required to declare
19
conflicts through the Royal Pharmaceutical Society register of interests .
Both the policies and declarations are available upon request.
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
6.4
Take account of any
potential for bias in the
conclusions or
recommendations of the
guidance
The process of evidence identification is systematic. Funding is
Criterion met
transparent, editorial independence from the funding source is achieved,
and there is a comprehensive policy for declaring and managing conflicts
of interest
6,18,19,20
. Together these steps help to ensure the possibility of
bias is reduced.
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Domain
Criterion
Evidence for meeting the criterion
Accreditation
decision
1 British National Formulary
2 British National Formulary for Children
3 BNF style guide
4 BNFC style guide
5 Style guide for hepatic, renal, pregnancy, and breast-feeding messages in BNF and BNFC
6 Standing Orders of the Formulary Committees of the British National Formulary
7 Standard reference sources
8 Nurse prescribers’ formulary
9 Journal allocation list
10 logs of systematic searches
11 Criteria for inclusion and exclusion of products in BNF and BNF for Children
12 transcripts of discussions by expert advisers, the JFC and PFC
13 Creating content for referential (human readable) BNF and BNFC
14 screenshot of an internal content change tracker
15 Online versions of the BNF and BNFC
16 BNF application for smart-phones
17 User research report
18 BNF and BNFC Advisors Terms of Reference
19 Royal Pharmaceutical Society register of interests
20 Declaration of Interests Form – Advisor
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Appendix B: Bibliography
Appendix B lists the additional information taken into account in the analysis and
considered by the committee.
Document name
Description
Location
Appendix 1: BNF and
Scenarios demonstrating use
supplied
BNFC Use Cases
of the BNF
Appendix 2: When to
Explains when expert
seek expert input on
advisers and committees are
clinical issues
used
Appendix 3: Creating
Process document for
content for referential
creating BNF and BNFC
(human readable) BNF
content
supplied
supplied
and BNFC
Appendix 4:
Example of expert adviser
Discussions: JFC Use
discussion over content
supplied
of aminoglycosides with
ototoxic diuretics
Appendix 5: Recruiting
Procedure for recruiting
a new adviser
expert advisers
Appendix 6: Standard
List of sources and quality
reference sources
criteria used by the BNF
Appendix 7: Readability
Demonstrates patient
Testing report for BNF
involvement in developing
supplied
supplied
supplied
Appendix 9 - Cautionary patient information
and advisory labels for
dispensed medicines
Appendix 8: BNF: latest
User research findings
supplied
List of journal sources
supplied
user research Oct 2012
Appendix 9: BNF
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Document name
Description
Location
journal allocation
11/2012
Appendix 10: Procedure Procedure for processing
supplied
for processing SPCs
SPCs
Appendix 11:
Example of processed SPC
supplied
SOP for checking doses
supplied
Appendix 13: BNF and
Terms of Reference for
supplied
BNFC Advisors Terms
expert advisors
Processed SPC for
Exembol [argatroban]
Appendix 12: BNF SOP
Checking doses
of Reference
Appendix 14: BNF
Standing Orders of the
Standing Orders of the
Formulary Committees of the
Formulary Committees
British National Formulary
supplied
of the British National
Formulary
Appendix 15: Criteria
Information on what types of
for inclusion and
products are covered
supplied
exclusion of products in
BNF and BNFC
Appendices 16a-d:
Email correspondence
Email correspondence
related to NYDA®
supplied
related to NYDA®
Appendix 17: BNF SOP
Information on how the list of
Processing the Nurse
medicines and devices in the
Prescribers’ Formulary
NPF is arrived at
supplied
lists
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Document name
Description
Location
Appendix 18: BNF SOP
Information on how the list of
supplied
Processing the Dental
dental medicines in the BNF
Practitioners’ Formulary
and BNFC is arrived at
lists
BNF Style guide
supplied
BNFC Style guide
supplied
BNFC Style guide
supplied
Appendix 22: BNF Side- BNFC Style guide
supplied
Appendix 19: BNF Style
guide
Appendix 20: BNFC
Style guide
Appendix 21: Style
guide for hepatic, renal,
pregnancy, and breastfeeding messages in
BNF and BNFC
effects help guide
Editorial guide
supplied
Style guide
supplied
Appendix 25: Google
Website statistics for BNF
supplied
analytics of BNF
website
Appendix 23: BNF
ACBS Product
placement decision
guide
Appendix 24: BNF
ACBS Style guide
website
Appendix 26: Royal
Declaration of interests form
Pharmaceutical Society
for the RPS
supplied
Register of Interests
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Document name
Description
Location
Appendix 27: British
Sample of evidence identified
supplied
Society of Antimicrobial
by searches
form
Chemotherapy
guidelines for the
antibiotic treatment of
endocarditis in adults
2012
supplied
Appendix 28: BNF
BSAC Endocarditis BNF
endocarditis
analysis (2012)
Appendix 29: BNF
Standing orders
supplied
Terms of reference
supplied
Declaration of interests form
supplied
SOP for developing the NPF
Supplied
Appendix 33: Extract of
Sample of evidence identified
supplied
NICE CG102: Bacterial
by searches
Standing Orders of the
Formulary Committees
of the British National
Formulary
Appendix 30: BNF and
BNFC Advisors Terms
of Reference
Appendix 31:
Declaration of Interests
Form – Advisor
Appendix 32: BNF SOP
Creating content for the
Nurse Prescribers’
Formulary for
Community
Practitioners
meningitis and
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Document name
Description
Location
Appendix 34: BNFC
Expert advisers’ review of
supplied
Adviser questions
evidence
meningococcal
septicaemia in children:
full guideline
posted on pre-hospital
antibiotics for meningitis
Appendix 35: JFC
JFC review of evidence
supplied
PFC review of evidence
supplied
PFC review of evidence
supplied
PFC review of evidence
supplied
PFC review of evidence
supplied
PFC review of evidence
supplied
JFC review of evidence
supplied
Expert advisers’ review of
supplied
paper on pre-hospital
antibiotics for meningitis
Appendix 36: PFC
paper on pre-hospital
antibiotics for meningitis
Appendix 37: PFC
paper on maximum
dose of adenosine
Appendix 38: PFC
paper on lisinopril heart
failure dose
Appendix 39: PFC
paper on the role of
spironolactone in
nephrotic syndrome
Appendix 40: PFC
paper on the nebulised
dose of colistimethate
sodium
Appendix 41: JFC
paper tiotropium
Appendix 42: BNFC
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Children: Accreditation Report for consultation
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Document name
Description
Adviser discussion on
evidence
Location
plasma concentration
monitoring of
colistimethate
Appendix 43: BNFC
Expert advisers’ review of
Adviser discussion on
evidence
supplied
benzylpenicillin dose in
neonates
Appendix 44: BNFC
Expert advisers’ review of
Adviser discussion on
evidence
supplied
intravenous infusion
dose of metronidazole
in neonates
Appendix 45: UK
Expert adviser review of BNF
Ophthalmic Pharmacy
chapter
supplied
Group comments on
chapter 11, BNF 64
Terms of reference
supplied
Drug safety update
supplied
Appendix 48: BNF and
Update of changes for BNF
supplied
BNF for Children
and BNFC
Appendix 46: BNF and
BNFC Advisors Terms
of Reference
Appendix 47: Drug
Safety Update March
2013 vol. 6, issue 8
update for health
professionals
Monthly important new
Letter from NICE detailing
information.pdf
changes to medicines
supplied
information of interest to the
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Document name
Description
Location
BNF
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Appendix C: NICE Accreditation Advisory Committee,
external advisers and NICE Accreditation team
NICE Accreditation Advisory Committee
The Accreditation Advisory Committee operates as a standing advisory committee of
the Board of the National Institute for Health and Care Excellence (NICE). The
Committee provides advice to NICE on a framework for accrediting sources of evidence
that should be recognised as trusted sources of information for the NHS. The chair of
the Committee is appointed by the NICE Board and the meetings are conducted by the
chair, or in his/her absence the vice chair. The current Chair is Martin Underwood. A full
list of the Advisory Committee membership is available on the NICE website. Members
are appointed for a period of 3 years. This may be extended by mutual agreement for a
further 3 years, up to a maximum term of office of 10 years.
The decisions of the Committee are arrived at by a consensus of the members present.
The quorum is set at 50% of committee membership. The Committee submits its
recommendations to the NICE Guidance Executive which acts under delegated powers
of the NICE Board in considering and approving its recommendations.
Committee members are asked to declare any interests in the guidance producer to be
accredited. If it is considered that there is a conflict of interest, the member is excluded
from participating further in the discussions. Committee members who took part in the
discussions for this accreditation decision are listed below.
Title
Name
Surname
Role
Organisation
Dr
Adrian
Brown
Principal Screening Advisor
NHS England
Professor
Ann
Caress
Professor of Nursing
University of Manchester
Ms
Joyce
Epstein
Lay member
Lay member
Dr
Elvira
Garcia
Public Health Medicine
Locum
Consultant
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Children: Accreditation Report for consultation
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Dr
Steve
Hajioff
General Practitioner and Public
Public Health England
Health Consultant
Ms
Ruth
Liley
Assistant Director of Quality
Marie Curie Cancer Care
Improvement
Professor
Stuart
Logan
Professor of Paediatric
Peninsula College of Medicine &
Epidemiology
Dentistry
Dr
Edward
Ng
General Practitioner
Ley Hill Surgery Sutton Coldfield
Dr
Carl
Parker
General practitioner
North Tees and Hartlepool
Foundation Trust
Dr
Mahendra
Dr
Karen
Patel
Ritchie
Senior Lecturer & Consultant
Universities of Huddersfield and
Pharmacist
Bradford
Head of Knowledge
Healthcare Improvement Scotland
Management
Ms
Mandy
Dr
Sainty
Pete
Smith
Research and Development
College of Occupational
Manager
Therapists
Vice President
National Association of Primary
Care
Dr
Sara
Twaddle
Head of Evidence &
Healthcare Improvement Scotland
Technologies / Director of SIGN
Professor
Martin
Underwood
Head of Division of Health
The University of Warwick
Sciences, Professor of Primary
Care Research
Dr
Stephen
Webb
Consultant in Anaesthesia &
Papworth Hospital NHS
Intensive Care Medicine
Foundation Trust
Deputies
Title
Ms
Name
Josephine
Surname
Kavanagh
Role
Research Officer
Organisation
Institute of Education
Deputising for
Professor Sandy Oliver
External Advisers for this application
Dr Andrea Hilton, Lecturer and practising pharmacist, University of Hull, UK
Dr Marlies Ostermann, Consultant in Critical Care and Nephrology, Guy's & St Thomas'
Hospital, London, UK
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Adrian Palfreeman, Consultant Physician University Hospitals Leicester, UK
Adrian Reyes-Hughes, Clinical Consultant, Clinical Strategy & Health Information
Services, UK
NICE Accreditation team for this application
James Stone, Accreditation Technical Analyst, National Institute for Health and Care
Excellence, Manchester, UK
Stephanie Birtles, Accreditation Technical Analyst, National Institute for Health and
Care Excellence, Manchester, UK
British National Formulary Publications: British National Formulary, British National Formulary for
Children: Accreditation Report for consultation
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