The Health service journal
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Health Serv J
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NICE has published 62 technology appraisal reports in three years. Many reports refer to complex, specialist topics and affect only small numbers of patients. Some opportunities to give clear guidelines have been missed. There is scope for reports designed to maximise existing NHS resources and to assess the role of prevention, care integration and other ways to cut long-term costs.
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The national service framework and planning and priorities framework put greater emphasis on children's services. Children's trust pilots show the wide array of approaches around the country. Service change is being driven in part by staff shortages and the new working time directive, putting a focus on job redesign.