Heart failure is appropriately described as an epidemic, with 1-2% of health care expenditure being directed at its management. In England, the National Institute for Health and Care Excellence (NICE) has issued guidance on the best practice for the diagnosis and treatment of acute and chronic heart failure. Echocardiography is key to the diagnosis of the underlying cardiac abnormalities, and a...

The role of the various agencies involved in the managed introduction of new drugs in the United Kingdom is discussed, particularly with regard to the work of the National Institute for Clinical Excellence (NICE). The process by which the National Health Service in the UK identifies key new drug technologies of major clinical, financial and service significance is discussed. This includes the d...

BACKGROUND All health care systems face the need to find the resources to meet new demands such as a new, cost-increasing health technology. In England and Wales, when a health technology is recommended by the National Institute for Health and Care Excellence (NICE), the National Health Service (NHS) is mandated to provide the funding to accommodate it within three months of publication of the ...

### What you need to know Pelvic organ prolapse is common in women over the age of 50 and negatively affects their quality life.1 Management includes lifestyle modification, pelvic floor muscle training, vaginal pessary, or surgery.2 Pessaries may be preferred by as an alternative surgery while they await surgery. In observational study UK (680 women), two thirds initially conservative managem...

BACKGROUND Guidelines are a common and important tool in providing high-quality health care. The National Institute for Health and Clinical Excellence (NICE) guidelines are now being used to set standards for assessing the quality of care in UK general practice, and so the evidence behind them needs to be relevant to primary care. AIM To assess the extent to which guideline recommendations ai...

The number of adolescents with Crohn's disease (CD) is rising, with one third of cases diagnosed before turning 21 years old. Evidence shows that long-term medical intervention, school absence and the physical toll of CD on the growing adolescent also have a psychological effect on patients. In addition, poorly defined transition pathways are extending these problems into adulthood. The Nationa...

In this Practice article (BMJ 2014;349:g4778, doi:10.1136/bmj. g4778) by Duffy and colleagues, an error occurred in the first paragraph. The authors provided a correction [http://www.bmj. com/content/349/bmj.g5173]which requires further clarification. The second sentence should now read: “The third stage of labour can be managed actively or physiologically, defined by the National Institute for...

In 2002, Kaiser Permanente (KP) launched its Women’s Health Center of Excellence in Culturally Competent Care in the KP Northern California Region’s Greater Southern Alameda Area (GSAA) Service Area, which includes the KP Fremont and Hayward Medical Centers. The KP National Diversity Program Offices’ Institute for Culturally Competent Care made this designation of excellence possible. The Insti...

Patients with psychotic illnesses are predicted to die 15 years younger than the national average. The chief cause is cardiovascular disease (1). Evidence-based guidelines including those produced by the National Institute of Health and clinical Excellence and the Quality Outcomes Framework, recommend regular monitoring of their cardiovascular risk (2,3,4). Primary health care audits were under...

Abstract Introduction Acute kidney injury (AKI) is a potentially avoidable complication in patients undergoing elective lower limb arthroplasty. The National Institute for Health and Care Excellence (NICE) offers guidelines to identity manage AKI. This closed loop audit aiming assess i) adherence NICE ii) whether simple interventions will improve compliance. Method We the on departmental carrie...