NICE

Consultation Documents (5th March 2010-18th March 2010)
NICE are now consulting on the following:

Barrett's oesophagus - ablative therapy: draft guideline consultation - closing date 7th April 2010

Nocturnal enuresis in children (bedwetting): guideline consultation - closing date 6th May 2010

Hypertension (update): scoping workshop, consultation and final scope - closing date 8th April 2010

Social and emotional wellbeing - vulnerable children at home: consultation on the draft scope - closing date 13th April 2010

Social and emotional wellbeing: early education and daycare: consultation on the draft scope - closing date 13th April 2010

Spasticity in Children: draft scope consultation - closing date 9th April 2010

Psoriatic arthritis - etanercept, infliximab & adalimumab (review): appraisal consultation document - closing date 8th April 2010

QOF Indicators in development - closing date 11th April 2010

Upper gastrointestinal bleeding: scope consultation - closing date 16th April 2010

Growth failure (in children) - human growth hormone (HGH) (review): final appraisal determination - closing date 1st April 2010

Latest Implementation Tools (11th March 2010)
Tools to aid implementation of latest guidance:

CG93 Donor Breast Milk Banks: audit support, costing tool and slide set

TA186 Rheumatoid arthritis - certolizumab pegol: audit support and costing tool

TA185 Soft tissue sarcoma - trabectedin: audit support and costing tool

PH23 School-based interventions to prevent smoking: slide set and costing tool

IPG331 Cytoreduction surgery followed by hyperthermic intraoperative peritoneal chemotherapy for peritoneal carcinomatosis (replacing of IPG116): audit support

IPG332 Surgical correction of hallux valgus using minimal access: audit support

Therapeutic endoscopic division of epidural adhesions (review of IPG88): audit support

NICE

Consultation documents (19th February 2010 - 3rd March 2010)

NICE are now consulting on the following:

Photodynamic therapy for Barrett's oesophagus: Interventional Procedures Consultation Document - closing date 23rd March 2010

Transperineal temlate biopsy of the prostate: Interventional Procedures Consultation Document - closing date 23rd March 2010

Percutaneous occlusion of the left atrial appendage in non-valvular atrial fibrillation for the prevention of thromboembolism: Interventional Procedures Consultation Document - closing date 23rd March 2010

Extracranial to intracranial bypass for intracranial atherosclerosis: Interventional Procedures Consultation Document - closing date 23rd March 2010

Stapled transanal rectal resection for obstructed defaecation syndrome: Interventional Procedures Consultation Document - closing date 23rd March 2010

Motor neurone disease - non-invasive ventilation: draft guideline for consultation - closing date 23rd March 2010

Caesarean section (update): scope consultation - closing date 24th March 2010

PSHE: consultation on the evidence - closing date 24th March 2010

Rheumatoid arthritis - drugs for treatment after failure of a TNF inhibitor: appraisal consultation document - closing date 24th March 2010

Rheumatoid arthritis - tocilizumab: appraisal consultation 3 - closing date 25th March 2010

Leukaemia (chronic lymphocytic, relapsed) - rituximab: final appraisal determination - closing date 18th March 2010

Myelodysplastic syndromes - azacitidine: final appraisal determination - closing date 18th March 2010

Crohn's disease - infliximab (review) and adalimumab: final appraisal determination - closing date 18th March 2010

Interventional Procedures Guidance IPG333. Therapeutic endoscopic division of epidural adhesions (24th February 2010)
Endoscopic epidural procedures are used to treat lower back pain, particularly when radiculopathy is present. The epidural space is examined with an endoscope and further interventions may then be performed, such as mobilising spinal adhesions or administering drugs to inflamed tissue.
Guidance

Interventional Procedures Guidance IPG332. Surgical correction of hallux valgus using minimal access techniques (24th February 2010)

Hallux valgus is a deformity of the big toe. The big toe tilts outwards, crowding the smaller toes, and a bony lump (called a bunion) appears on the inside of the foot.

Under local or general anaesthesia, one or more small cuts are made to insert bone-cutting instruments. These are used to remove the bunion and to divide one or more of the bones of the front of the foot. The divided bones may need to be stabilised with wires, screws or plates. The aim is to correct the tilting of the big toe. The operation is monitored by X-rays or an endoscope (a telescope for looking inside the body). Compared with standard (open) surgery, this procedure uses smaller cuts to the foot and X-rays or endoscopy to see inside the foot.
Guidance

Interventional Procedure Guidance IPG331. Cytoreduction surgery followed by heyperthrmic introperative peritoneal chemotherapy for peritoneal carcinomatosis (24th February 2010)

Peritoneal metastases commonly result from the regional spread of gastrointestinal, gynaecological and other malignancies. Peritoneal carcinomatosis is an advanced form of cancer associated with short survival and poor quality of life, which may lead to bowel obstruction, ascites and pain.

This procedure was developed by Paul Sugarbaker at the Washington Cancer Institute. A laparotomy is performed under general anaesthesia and all gross tumour is removed along with the involved organs, peritoneum and tissue. The surgery includes:

• removal of the right hemicolon, spleen, gall bladder, parts of the stomach, greater omentum and lesser omentum
• stripping of the peritoneum from the pelvis and diaphragm
• stripping of tumour from the surface of the liver
• removal of the uterus and ovaries in women
• removal of the rectum in some cases.

Guidance

Technology Appraisal Guidance TA185. Trabectedin for the treatment of advanced soft tissue sarcoma (24th February 2010)

Trabectedin is recommended as a possible treatment for people with advanced soft tissue sarcoma if:

• treatment with anthracyclines and ifosfamide has failed, or
• they cannot tolerate anthracyclines and ifosfamide, or
• anthracyclines and ifosfamide are unsuitable.

The manufacturer of trabectedin has agreed to a 'patient access scheme', which means that when a person needs more than five trabectedin treatments, it provides the sixth and any further trabectedin treatments to the NHS free of charge.
Guidance

Technology Appraisal Guidance TA186. Certolizumab pegol for the treatment of rheumatoid arthritis (24th February 2010)

Certolizumab pegol is recommended as a possible treatment for people with rheumatoid arthritis who:

• have already tried methotrexate and another disease-modifying anti-rheumatic drug (DMARD), usually for at least 6 months,and
• have severe 'active' rheumatoid arthritis, as assessed by arheumatologist on two separate occasions

People who are treated with certolizumab pegol should normally also be given methotrexate. If methotrexate does not suit them, they may be given certolizumab pegol on its own.
Guidance

Clinical Guidelines CG93. Donor breast milk banks: the operation of donor breast milk bank services (24th February 2010)

The advice in the NICE guideline covers:

• How milk banks should recruit, screen and support women who donate breast milk
• How milk banks should handle and process the breast milk they receive from donors.

It does not specifically look at:

• How donated breast milk is used after it leaves the milk bank
• The care and treatment of babies who receive donated breast milk
• How mothers should handle and store breast milk for their own babies.

Guidelines

Public Health Guidance PG23. School-based interventions to prevent the uptake of smoking among children (24th February 2010)

This guidance is for all those responsible for preventing the uptake of smoking by children and young people aged under 19. This includes those working in the NHS, local authorities, education and the wider public, private, voluntary and community sectors. It may also be of interest to children and young people, their parents or carers and other members of the public.

The five recommendations include the following advice:

• The smoking policy should support both prevention and stop smoking activities and should apply to everyone using the premises (including the grounds).
• Information on smoking should be integrated into the curriculum. For example, classroom discussions could be relevant when teaching biology, chemistry, citizenship and maths.
• Anti-smoking activities should be delivered as part of personal, social, health and economic (PHSE) and other activities related to Healthy Schools or Healthy Further Education status.
• Anti-smoking activities should aim to develop decision-making skills and include strategies for enhancing self-esteem. Parents and carers should be encouraged to get involved and students could be trained to lead some of these programmes.
• All staff involved in smoking prevention should be trained to do so.
• Educational establishments should work in partnership with outside agencies to design, deliver, monitor and evaluate smoking prevention activities.

Guidance

NICE

Consultation documents (4th February-18th February 2010)
NICE are now consulting on the following:

Contraceptive Services for socially disadvantaged young people: consultation on the evidence - closing date 8th March 2010

Tuberculosis - hard to reach groups: consultation on the draft scope - closing date 9th March 2010

Imatinib-intolerant chronic myeloid leukaemia - dasatinib and nilotinib: appraisal consultation document - closing date 2nd March 2010

Diabetic foot problems - inpatient management: draft scope for consultation - closing date 9th March 2010

Renal cell carcinoma (second line metastatic) - everolimus: appraisal consultation document - closing date 2nd March 2010

Diabetes - liraglutide: appraisal consultation document - closing date 5th March 2010

Looked after children: consultation on the draft guidance - closing date 14th April 2010

Pregnancy and complex social factors: guideline consultation - closing date 12th April 2010

Weight management in pregnancy and after childbirth: consultation on draft guidance - closing date 18th March 2010

Latest Implementation Tools (10th February 2010)
Tools to aid implementation of latest guidance

CG92 Venous thromboembolism - reducing the risk: audit support, costing tool, guide to resources and slide set

NICE

NICE's original guidance on preventing fractures due to osteoporosis still stands following challenge (29th January 2010)
Following a legal challenge to the process used to produce NICE’s existing guidance on prevention of osteoporotic fractures, the original recommendations remain unchanged in the updated guidance documents published today (29 January 2010).

This means that postmenopausal women with osteoporosis at risk of fractures will continue to have access to a range of drugs to help either prevent them suffering a first fracture (primary prevention) or prevent further fractures after they have suffered one (secondary prevention). The guidance documents have been updated to reflect the Appraisal Committee’s consideration of the additional stakeholder comments received following a further consultation in line with the court judgement. The treatments NICE recommends for primary and secondary prevention of osteoporotic fractures are not affected, and the range of options still stands.
Press Release

Consultation Documents (21st January - 3rd February 2010)
NICE are now consulting on the following:

Rheumatoid arthritis - certolizumab pegol: final appraisal determination - closing date for comments is 4th February 2010

Stroke rehabilitation: scope consultation - closing date for comments is 24th February 2010

Lung cancer (non-small-cell, first line) - gefitinib: appraisal consultation document - closing date for comments is 18th February 2010

Mini-incision surgery for total knee replacement - Interventional Procedures Consultation Document - closing date for comments is 24th February 2010

Single port incision surgery for laparoscopic cholecystectomy - Interventional Procedure Consultation Document - closing date for comments is 24th February 2010

Circumferential epithelial radiofrequency ablation for Barrett's oesophagus - Interventional Procedures Consultation Document - closing date for comments is 24th February 2010

Therapeutic hypothermia with intracorporeal temperature monitoring for hyposic perinatal brain injury - Interventional Procedures Consultation Document - closing date for comments is 24th February 2010

Endoscopic saphenous vein harvest for coronary artery bypass grafting - Interventional Procedures Consultation Document - closing date for comments is 24th February 2010

Citizens Council report: smoking and harm reduction, with invitation to comment - closing date for comments is 31st March 2010

Clinical Guidelines CG92 Reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital (27th January 2010)
This guidance is about the care and treatment of people who are at risk of developing deep vein thrombosis (DVT) while in hospital in the NHS in England and Wales.

The advice in the NICE guideline covers the care and treatment that should be offered to:

• all adults (aged 18 and over) who are admitted to hospital as inpatients (including those admitted for day-case procedures).

It does not cover the care and treatment that should be offered to:

• people under the age of 18
• people attending hospital as outpatients
• people attending emergency departments who are not admitted to hospital
• older people who are cared for at home or in residential care homes
• people who are immobile and are cared for at home or in residential care homes
• people who are admitted to hospital because they have a diagnosis or signs and symptoms of DVT or pulmonary embolism.

Guidance

NICE

Consultation Documents (1st January 2010 - 20th January 2010)
Nice are now consulting on the following:

Food allergy in children: scope consultation - closing date for comments is 8th February 2010

Chronic heart failure (partial update) draft guideline consultation - closing date for comments is 10th March 2010

Preventing obesity: a whole-system approach: consultation on the draft scope - closing date for comments is 12th February 2010

Transient loss of consciousness in adults: guideline consultation - closing date for comments is 17th March 2010

Latest Implementation Tools (13th January 2010)
Tools to aid implementation of latest guidance

CG90 Depression in adults: audit support

CG91 Depression with a chronic physical health problem: audit support

IPG324 Electrocautery cutting balloon treatment for pelviureteric junction obstruction: audit support

IPG322 Negative pressure wound therapy for the open abdomen: audit support

IPG329 Total prosthetic replacement of the temporomandibular joint: audit support

IPG330 Vagus nerve stimulation for treatment- resistant depression: audit support

NICE

Consultation Documents (14th December 2009 - 29th December 2009)
NICE are now consulting on the following:

Review of the guide to the technology appraisal appeal process - closing date for comments is 22nd March 2010

Rheumatoid arthritis - tocilizumab: appraisal consultation document 2 - closing date for comments is 20th January 2010

Lung cancer (non-small-cell) - pemetrexed (maintenance): appraisal consultation document - closing date for comments is 21st January 2010

Soft tissue sarcoma - trabectedin: final appraisal determination - closing date for comments is 18th January 2010

Transanal haemorrhoidal dearterialisation - closing date for comments is 27th January 2010

Laparoscopic radical hysterectomy for early stage cervical cancer - closing date for comments is 27th January 2010

Macular translocation with 360^o retinotomy for wet age related macular degenertion - closing date for comments is 27th January 2010

Macular translocation for wet age-related macular degeneration - closing date for comments is 27th January 2010

Interventional Procedures Guidance IPG322. Negative pressure wound therapy for the abdomen (16th December 2009)
Emergency surgery for trauma or severe infection may lead to a wound being left open on the trunk. Such wounds may take many months to heal. Negative pressure wound therapy uses a dressing inserted against the bowel, tubing and suction a small vacuum unit to apply suction to the wound, with the aims of reducing healing time and simplifying wound management. The dressing may be left in place for days or weeks.
Guidance

Interventional Procedures Guidance IPG323. Balloon catheter insertion for Bartholin's cyst or abscess (16th December 2009)
The Bartholin’s glands are at the entrance of the vagina. A cyst or abscess can form in the Bartholin’s duct (which drains the glands) if it becomes blocked or infected. Cysts are usually treated either by ‘incision and drainage’ or ‘marsupialisation’, which involves cutting into the cyst and placing stitches to make a permanent opening so that the gland can drain freely. Insertion of a balloon catheter is a non-surgical alternative to incision and drainage or marsupialisation.
Guidance

Interventional Procedures Guidance IPG324. Electrocautery cutting balloon treatment for pelviureteric junction obstruction (16th December 2009)
Pelviureteric junction obstruction is a condition caused by a narrowing of the funnel-shaped part of the kidney (known as the renal pelvis) where urine collects before being carried to the bladder by tubes called ureters. The obstruction may cause episodes of loin pain and/or nausea and vomiting, urinary infections and kidney stones. In some patients the condition could also affect the normal function of the kidney.

This procedure (electrocautery cutting balloon treatment) aims to widen the renal pelvis by inserting a catheter with a balloon and wire into the urinary tract. The wire is used to cut away the tissue that is causing the obstruction.
Guidance

Interventional Procedures Guidance IPG325. Endopyelotomy for pelviureteric junction obstruction (16th December 2009)
Pelviureteric junction obstruction is a condition caused by a narrowing of the funnel-shaped part of the kidney (known as the renal pelvis) where urine collects before being carried to the bladder by tubes called ureters. The obstruction may cause episodes of loin pain and/or nausea and vomiting, urinary infections and kidney stones. In some patients the condition could also affect the normal function of the kidney.

This procedure (endopyelotomy) aims to widen the renal pelvis by inserting small instruments either up through the urinary tract or down through the skin and into the kidney. The instruments are used to remove the tissue that is causing the obstruction by cutting or burning it away or by applying laser.
Guidance

Interventional Procedures Guidance IPG326. Laparoscopic augentation cystoplasty (including clam cystoplasty) (16th December 2009)
An ‘overactive bladder’ or detrusor hyper-reflexia causes symptoms of urgent need to urinate, urge incontinence, frequent urination and waking at night to urinate. One of the causes is bladder muscle (detrusor) overactivity, in which the detrusor contracts unexpectedly during bladder filling. Laparoscopic augmentation cystoplasty (including clam cystoplasty) is reconstructive surgery to increase the size of the bladder and is done via small incisions. The procedure involves sewing or stapling a tissue graft from a section of the small intestine (ileum), colon or other substitutes to the urinary bladder.
Guidance

Interventional Procedures Guidance IPG327. Radiofrequency ablation for the treatment of colorectal liver metastases (16th December 2009)
Colorectal cancer is a type of cancer that develops in the bowel (including the colon and rectum). In some patients, cancer cells could spread from the bowel to other parts of the body to form one or more ‘secondary tumours’, also known as ‘metastases’. For bowel cancer, most commonly secondary tumours occur in the liver.

Radiofrequency ablation uses heat to destroy cancer cells in the liver. It involves placing one or more electrodes into the tumour. The electrodes are used to heat the tumour with the aim of destroying it. Radiofrequency ablation can be applied through the skin or during surgery.
Guidance

Interventional Procedure Guidance IPG328. Suction diathermy adenoidectomy (16th December 2009)
Adenoids are small lumps of lymphoid tissue at the back of the nose, which are part of the immune system. They are largest in young children and usually disappear by adulthood. An adenoidectomy is an operation to remove the adenoids if they become enlarged and are thought to be causing health problems such as ‘glue ear’. Suction diathermy adenoidectomy is a type of surgery to remove the adenoids using heat and suction.
Guidance

Interventional Procedures Guidance IPG329. Total prosthetic replacement of the temporomandibular joint (16th December 2009)
The temporomandibular joint (TMJ) is formed by the temporal bone of the cranium (skull) and the lower jaw or mandible. Symptoms of degenerative disease in this joint include dysfunction or pain in the head, face, jaws, neck and shoulders. TMJ replacement involves substituting a prosthesis, usually metal-on-metal or metal-on-acrylic, for the TMJ. The procedure takes 2–3 hours and the patient is usually in hospital for a few days afterwards.
Guidance

Interventional Procedures Guidance IPG330. Vagus nerve stimulation for treatment - resistant depression (16th December 2009)
Depression is associated with feelings of sadness, despair, helplessness, hopelessness and lack of interest in life. People with severe depression may be unable to eat or sleep or to take part in social activities, and they may become completely withdrawn. Vagus nerve stimulation aims to improve mood regulation and reduce depression by stimulating the nerve in the neck that carries signals to the brain areas involved. A generator implanted under the skin in the chest area is used to provide electrical stimulation to the nerve.
Guidance

NICE

Consultation Documents (25th November - 9th December 2009)
NICE are now consulting on the following documents:

Infection control (update): consultation on the draft scope - closing date for comments is 23rd December 2009

Draft stroke quality standard - closing date for comments is 15th January 2010

Draft dementia quality standard - closing date for comments is 15th January 2010

Donor breast milk banks: guideline pre-publication check - closing date for comments is 14th December 2009

Quitting smoking in pregnancy and following childbirth: draft guidance consultation - closing date for comments is 8th January 2010

Metastatic malignant disease of unknown primary origin: guideline consultation - closing date for comments is 1st February 2010

TA161 Osteoporosis - secondary prevention including strontium ranelate: final appraisal determination 2 - closing date for comments is 21st December 2009

TA160 Osteoporosis - primary prevention: final appraisal determination 2 - closing date for comments is 21st December 2009

Growth failure (in children) - human growth hormone (HGH) (review): appraisal consultation document - closing date for comments is 11th January 2010

Tuberculosis: interferon gamma tests (update): scope consultation - closing date for comments is 11th January 2010

Latest Implementation Tools (9th December 2009)

Tools to aid implementation of latest guidance:

PH21 Reducing the differences in the uptake of immunisations: audit support, Guide to Resources and Frequently Asked Questions

PH22 Promoting mental wellbeing at work: advice for small and medium-sized businesses

IPG320 Photochemical corneal collagen cross-linkage using riboflavin and ultraviolent A for keratoconus: audit support

IPG319 Percutaneous intradiscal electrothermal therapy for low back pain: audit support

TA184 Lung cancer (small-cell) - topotecan: audit support

IPG318 Bronchoscopic lung volume reduction with airway valves for advanced emphysema: audit support

IPG321 Lateral (including extreme, extra and direct lateral) interbody in the lumbar spine: audit support

NICE

Consultation Documents (11th November - 24th November 2009)
NICE are now consulting on the following documents:

Delirium: draft guideline consultation - closing date for comments is 6th January 2010

Chronic myeloid leukaemia: dasatinib and nilotinib: appraisal consultation document - closing date for comments is 7th December 2009

Crohn's disease: infliximab (review) and adalimumab: appraisal consultation document - closing date for comments is 10th December 2009

Weight management after childbirth (consultation on the evidence) - closing date for comments is 17th November 2009

Hepatocellular carcinoma (advanced and metastatic): sorafenib (first line): final appraisal determination - closing date for comments is 3rd December 2009

Skin cancer (update): consultation on the draft guidance - closing date for comments is 21st December 2009

Ultrasound guided transbronchial biopsy for peripheral lung lesions (interventional procedures consultation) - closing date for comments is 21st December 2009

Endoscopic submucosal dissection of lower gastrointestinal lesions (interventional procedures consultation) - closing date for comments is 21st December 2009

Transcatheter endovascular closure of perimembranous ventricular septal defect (interventional procedures consultation) - closing date for comments is 21st December 2009

Arteriovenous crossing sheathotomy for branch retinal veing occlusion (interventional procedures consultation) - closing date for comments is 21st December 2009

Colorectal cancer (metastatic): bevacizumab (appraisal consultation document) - closing date for comments is 14th December 2009

Interventional Procedures Guideline IPG319. Percutaneous intradiscal electrothermal therapy for low back pain (23rd November 2009)
The National Institute for Health and Clinical Excellence (NICE) has reviewed this guidance, after consultation, which was originally issued in August 2004. The guidance has now been updated and published along with the consultation comments and audit support.
Guidance

Interventional Procedures Guideline IPG318. Bronchoscopic lung volume reduction with airway valves for advanced emphysema (23rd November 2009)
Emphysema is a disease of the lungs in which the walls of the air sacs become weak and disintegrate, leaving behind abnormally large air spaces that stay filled with air even when the person breathes out. The lungs also become less able to get enough oxygen into the blood, so the person can feel tired and breathless.

The aim of lung volume reduction surgery is to limit airflow to the part of the lung that's working least well, so that the effort of breathing can be concentrated on the part of the lung that's working better. The procedure is undertaken via a small flexible camera inserted down the wind pipe and placing small, one-way valves in the airways. A typical procedure involves placing 3-4 valves.
Guidance

Interventional Procedures Guidance IPG320. Photochemical corneal collagen cross-linkage using riboflavin and ultraviolet A for keratoconus (25th November 2009)
Keratoconus is a degenerative condition that usually involves both eyes. It affects the shape of the eyeball and causes blurred vision and light sensitivity. Wearing spectacles or contact lenses can help some people who have this condition. Photochemical corneal collagen cross-linkage is an outpatient procedure. First a local anaesthetic is given in the form of eye drops. Then riboflavin (vitamin B2) drops are applied to the eye, and it is exposed to ultraviolet light. This procedure aims to stabilise the outer coating of the eyeball, called the cornea, with the intention of preventing further changes to its shape.
Guidance

Interventional Procedures Guidance IPG321. Lateral (including extreme, extra and direct lateral) interbody fusion in the lumbar spine (25th November 2009)
As a person gets older, the discs between the back bones that provide support can deteriorate because of wear and tear. Sometimes this causes such severe pain and disability that surgery is considered.

Lateral interbody spinal fusion involves the removal of all, or part, of the damaged disc and the insertion of a supportive structure, together with a fragment of bone from the hip. It aims to join the two back bones together to prevent movement of the painful joint. The procedure is done through a cut in the patient’s side.
Guidance

Technology Appraisal TA184. Lung cancer (small-cell) - topotecan (25th November 2009)
Oral topotecan is recommended as a possible treatment for people with relapsed small-cell lung cancer if:

• re-treatment with the previous treatment is not considered appropriate and
• there is a medical reason why they cannot take the combination of cyclophosphamide, doxorubicin and vincristine (CAV)

Intravenous topotecan is not recommended for people with relapsed small-cell lung cancer.
Guidance

NICE

Consultation Documents
NICE are now consulting on the following documents:

Colorectal cancer in patients with ulcerative colitis, Crohn's disease and polyps - closing date for comments is 25th November 2009

Prevening unintentional injuries in the home among under 15s: providing safety equipment and home-risk assessments - closing date for comments is 2nd December 2009

Preventing unintentional road injuries among under 15s: road design - closing date for comments is 2nd December 2009

Thrombocytopenic purpura: romiplostim - closing date for comments is 26th November 2009

Leukaemia (chronic lymphocytic, relapsed): rituximab - closing date for comments is 1st December 2009

Chronic obstructive pulmonary disease (update) - closing date for comments is 5th January 2010

Public Health Guidance PH22. Promoting mental wellbeing at work (5th November 2009)
The guidance is for those who have a direct or indirect role in, and responsibility for, promoting mental wellbeing at work. This includes all employers and their representatives, irrespective of the size of the business or organisation and whether they are in the public, private, or voluntary sectors. It may also be of interest to professionals working in human resources or occupational health, employees, trade unions representatives and members of the public.
Guidance

Latest Implementation Tools (11th November 2009)
Tools to aid implementation of latest NICE Guidance.

CG90 Depression in adults: Costing Statement

CG91 Depression in adults with a chronic physical health problem: Costing Statement

TA182 Acute coronary syndrome - prasurgrel: Audit Support and Costing Template

TA183 Cervical cancer (recurrent) - topotecan: Audit Support and Costing Statement

PH22 Promoting mental wellbeing at work: Costing Tool for Employers and Slide Set

NICE

New database to inform prioritisation of European cancer research (20th October 2009)
A 'Database of Cancer Uncertainties' (DoCU) went live on the NICE website today. The database will collate details of the major gaps in evidence which are identified during guidance development. These evidence gaps can then be promoted as research priorities to prospective research funders.

The database has been developed as a pilot project by NICE, as part of the CoCanCPG (Coordination of Cancer Clinical Practice Guidelines in Europe). CoCanCPG is a consortium of 16 institutional partners from 11 countries.
Database

What do you think about the NICE website? (27th October 2009)
As part of their continuing programme of evaluation and development, NICE are currently consulting with health service and local government professionals, patients, carers and the public to find out what they think of the NICE website.

The survey is available online until 15th November 2009.
Survey

Neuropathic pain - pharmacological management: guideline consultation (14th October 2009)
A clinical practice guideline on Neuropathic pain is being developed for use in the NHS in England, Wales and Northern Ireland. Registered stakeholders for this guideline are invited to comment on the provisional recommendations via this website.

Closing date for comments is 11th November 2009
Consultation

Prevention of cardiovascular disease: additional evidence consultation (14th October 2009)
NICE was asked by the Department of Health (DH) to develop public health programme guidance on preventing cardiovascular disease (CVD) in different populations.

All registered stakeholders are now invited to comment on the economic analysis and additional evidence that has been assembled to inform the development of this guidance. This will be used by the Programme Development Group (PDG) to develop recommendations.

Closing date for comments is 16th November 2009.
Consultation

Prevention of cardiovascular disease: consultation on the draft guidance (15th October 2009)
NICE are consulting on the draft guidance ‘prevention of cardiovascular disease at the population level’. In particular, they are interested in the views of stakeholders on recommendations 3, 4 and 5 (on salt, saturated fats and trans fats). They are interested in views on:

• Whether a figure for a lower target for salt intake could or should be identified at this stage
• Whether an even lower saturated fat intake is achievable
• The potential impact of a ban on industrial trans fats on cardiovascular disease in general and particularly the potential effects on existing inequalities in health.

NICE also welcome comments about other recommendations and sections of the guidance. Closing date for comments is 16th November 2009.
Consultation

Rheumatoid arthritis - certolizumab pegol: appraisal consultation (20th October 2009)
This appraisal consultation on Rheumatoid arthritis - certolizumab pegol, is open for comments until 10th November 2009. All registered stakeholders are invited to comment.
Consultation

Breast cancer (advanced or metastatic) - lapatinib: appraisal consultation document (21st October 2009)
The Department of Health and the Welsh Assembly Government have asked the National Institute for Health and Clinical Excellence (NICE) to produce guidance on using lapatinib for the treatment of women with previously treated advanced or metastatic breast cancer in the NHS in England and Wales. The Appraisal Committee has considered the evidence submitted by the manufacturer and the views of non-manufacturer consultees and commentators, and clinical specialists and patient experts.

Closing date for comments is 11th November 2009.
Consultation

Cytoreduction surgery followed by hyperthermic intraoperative peritoneal chemotherapy for peritoneal carcinomatosis (interventional procedures consultation) (21st October 2009)
The National Institute for Health and Clinical Excellence (NICE) is examining cytoreduction surgery followed by hyperthermic intraoperative peritoneal chemotherapy for peritoneal carcinomatosis and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. NICE’s Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about cytoreduction surgery followed by hyperthermic intraoperative peritoneal chemotherapy for peritoneal carcinomatosis.

Closing date for comments is 18th November 2009.
Consultation

Therapeutic endoscopic division of epidural adhesions (interventional procedures consultation) (21st October 2009)
The National Institute for Health and Clinical Excellence (NICE) is examining therapeutic endoscopic division of epidural adhesions and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. NICE’s Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about therapeutic endoscopic division of epidural adhesions.

Closing date for comments is 18th November 2009.
Consultation

Surgical correction of hallux valgus using minimal access techniques (interventional procedures consultation) (21st October 2009)
Hallux valgus is a deformity of the big toe. The big toe tilts outwards, crowding the smaller toes, and a bony lump (called a bunion) appears on the inside of the foot.

The National Institute for Health and Clinical Excellence (NICE) is examining surgical correction of hallux valgus using minimal access techniques and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. NICE’s Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about surgical correction of hallux valgus using minimal access techniques.

Closing date for comments is 18th November 2009.
Consultation

Selective internal radiation therapy for colorectal metastases in the liver (interventional procedures consultation) (21st October 2009)
Colorectal liver metastasis is cancer that has spread to the liver from the bowel. Selective internal radiation therapy (known as SIRT) uses radiation put into the patient’s liver to kill the cancer cells. Tiny radioactive ‘beads’ are injected into the artery that supplies blood to the liver (the hepatic artery). The beads become trapped (embolise) in the tiny blood vessels surrounding the cancer, releasing radiation directly onto it. The treatment may be repeated.

The National Institute for Health and Clinical Excellence (NICE) is examining selective internal radiation therapy for colorectal metastases in the liver and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. NICE’s Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about selective internal radiation therapy for colorectal metastases in the liver.

Closing date for comments is 18th November 2009.
Consultation

Prosthetic intervertebral disc replacement in the cervical spine (interventional procedures consultation)(21st October 2009)
Bulging of a disc (called herniation) in the neck occurs when one or more of the spinal discs between the bones in the neck bursts and pushes against the spinal cord or nerve roots that run through the backbone. This herniation can cause pain in the neck, or pain, weakness and numbness in the arms and legs.

This procedure involves replacing damaged discs in the neck with artificial ones designed to act like natural neck discs.

The National Institute for Health and Clinical Excellence (NICE) is examining prosthetic intervertebral disc replacement in the cervical spine and will publish guidance on its safety and efficacy to the NHS in England, Wales, Scotland and Northern Ireland. NICE’s Interventional Procedures Advisory Committee has considered the available evidence and the views of Specialist Advisers, who are consultants with knowledge of the procedure. The Advisory Committee has made provisional recommendations about prosthetic intervertebral disc replacement in the cervical spine.

Closing date for comments is 18th November 2009.
Consultation

Venous thromboembolism - reducing the risk: pre-publication check (22nd October 2009)
Following two consultation periods on the provisional recommendations, the National Clinical Guidelines Centre for Acute and Chronic Conditions (NCGC) and the Guideline Development Group (GDG) for Venous thromboembolism – reducing the risk, have considered and responded to stakeholder comments and amended the draft guideline.

The revised full guideline is now available on the web for a pre-publication check of factual errors. This is still draft guidance and has not been sent out to the NHS. The pre-publication check is not an additional consultation or an opportunity to reopen arguments and issues highlighted during consultation on the draft guidelines. The GDG will already have considered these issues in forming the recommendations contained in the draft for the pre-publication check.

Registered stakeholders for this guideline are invited to report any factual errors in the guideline by 11th November 2009.
Pre-publication check

Weight management in pregnancy: consultation on the evidence (22nd October 2009)
NICE was asked by the Department of Health (DH) to develop guidance on ‘Dietary interventions and physical activity interventions for weight management in pregnancy’.

All registered stakeholders are now invited to comment on the evidence that has been assembled to inform the development of this guidance. This evidence will be used by the Public Health Interventions Advisory Committee (PHIAC) to develop draft recommendations. The evidence comprises a review of effectiveness an economic analysis.

Closing date for comments is 19th November 2009.
Consultation

Bacterial meningitis and meningococcal septicaemia in children: guideline consultation (22nd October 2009)
A clinical practice guideline on Bacterial meningitis and meningococcal septicaemia in children is being developed for use in the NHS in England, Wales and Northern Ireland. Registered stakeholders for this guideline are invited to comment on the provisional recommendations.

Closing date for comments is 17th December 2009.
Consultation

Strategies to prevent unintentional injuries among under 15s: consultation on the evidence (26th October 2009)
NICE was asked by the Department of Health (DH) to ‘Prepare public health programme guidance on the prevention of unintentional injury in children under 15’.

All registered stakeholders are now invited to comment on the evidence that has been assembled to inform the development of this guidance. This evidence is used by the Programme Development Group (PDG) to develop draft recommendations.

Closing date for comments is 23rd November 2009.
Consultation

Technology Appraisal TA182. Prasugrel for the treatment of acute coronary syndromes with percutaneous coronary intervention (28th October 2009)
Prasugrel in combination with aspirin is recommended as an option for preventing blockages in the arteries of people with acute coronary syndromes who are having a treatment called percutaneous coronary intervention only when:

• immediate percutaneous coronary intervention is necessary to treat an ST-segment-elevation myocardial infarction (a type of heart attack) or
• a blood clot has blocked a stent (a small mesh-like tube inserted into an artery to keep it open) during treatment with a drug called clopidogrel or
• the patient has diabetes mellitus.

Guideline

Technology Appraisal TA183. Topotecan for the treatment of recurrent carcinoma of the cervix (28th October 2009)
Topotecan in combination with cisplatin is recommended as a possible treatment for women with recurrent or stage IVB cervical cancer only if they have not received cisplatin before. Healthcare professionals should not stop prescribing topotecan for women who have received cisplatin before and who were already taking topotecan with cisplatin when the guidance was issued. These women should be able to carry on taking topotecan until they and their healthcare professionals decide that it is the right time to stop treatment.
Guideline

Clinical Guideline CG90. Depression: the treatment and management of depression in adults (update) (28th October 2009)
This guideline is published alongside ‘Depression in adults with a chronic physical health problem: treatment and management’ (NICE clinical guideline 91), which makes recommendations on the identification, treatment and management of depression in adults aged 18 years and older who also have a chronic physical health problem.
Guideline

Clinical Guideline CG91. The treatment and management of depression in adults with chronic physical health problems (partial update of CG23)
This guideline is published alongside ‘Depression: the treatment and management of depression in adults (update)’ (NICE clinical guideline 90), which makes recommendations on the identification, treatment and management of depression in adults aged 18 years and older, in primary and secondary care.

This guideline (and CG90) update recommendations made in NICE technology appraisal guidance 97 for the treatment of depression only. The guidance in TA97 remains unchanged for the use of CCBT in the treatment of panic and phobia and obsessive compulsive disorder.
Guideline

RISK MANAGEMENT

Joint Statement: How compliance with NICE guidance can help you manage risk and optimise your resources (27th October 2009)
This joint statement from the NHS Litigation Authority (NHSLA) and NICE explains how complying with NICE guidance can help organisations manage risk and also optimise their resources. Criterion 5.8 of the NHSLA risk management standards focus on compliance with NICE guidance and the NHSLA have added some new questions and answers to their frequently asked questions (FAQ) to help organisations achieve the requirements.
Joint Statement
FAQ

NICE

Rheumatoid arthritis - tocilizumab: appraisal consultation (1st October 2009)
The Department of Health asked the National Institute for Health and Clinical Excellence (NICE) to produce guidance on using tocilizumab for the treatment of rheumatoid arthritis in the NHS in England and Wales. The Appraisal Committee considered the evidence submitted by the manufacturer and the views of non-manufacturer consultees and commentators, and clinical specialist and patient experts.

This document has been prepared for consultation with the consultees. It summarises the evidence and views that have been considered, and sets out the draft recommendations made by the Committee.

Closing date for comments is 22nd October 2009.
Consultation

Constipation in children: guideline consultation (1st October 2009)
A clinical practice guideline on Constipation in children is being developed for use in the NHS in England, Wales and Northern Ireland. Registered stakeholders for this guideline are invited to comment on the provisional recommendations via the NICE website.

Closing date for comments is 25th November 2009.
Consultation

Identification and care pathways for common mental health disorders: scope consultation (2nd October 2009)
NICE have been asked to develop a clinical practice guideline on Common mental health disorders: identification, assessment and care pathways for common mental health disorders for use in the NHS in England, Wales and Northern Ireland. The draft scope defines what aspects of care the guideline will cover and to whom it will apply. Registered stakeholders for the Common mental health disorders: identification and care pathways guideline are invited to submit comments on the scope and may suggest clinical questions that could be answered in the guideline.

Closing date for comments is 30th October 2009.
Consultation

Consultation on NICE response to Kennedy Report (October 2009)
NICE is now inviting comments on its response to Professor Sir Ian Kennedy’s report Appraising the Value of Innovation.

Closing date for comments is 13th January 2010.
Consultation

Alcohol-use disorders (prevention): consultation on the draft guidance (13th October 2009)
NICE is developing public health programme guidance (Alcohol-use disorders: preventing the development of hazardous and harmful drinking).

All registered stakeholders for the above public health programme guidance are invited to comment on the draft guidance.

Closing date for comments is 10th November 2009.
Consultation

Latest Implementation Tools (14th October 2009)
Tools to aid implementation of latest NICE guidance.

CG89 When to suspect child maltreatment: Audit Support

TA179 Gastrointestinal stromal tumours - sunitinib: Costing Template and Audit Support

TA181 Lung Cancer (non-small cell, first line treatment) - pemetrexed: Costing Template and Audit Support

TA180 Psoriasis - ustekinumab: Costing Statement and Audit Support

PH20 Social and emotional wellbeing in secondary education: Costing Statement and Slide Set

PH21 Reducing the differences in the uptake of immunisations: Costing Statement

IPG316 Extracorporeal albumin dialysis for acute liver failure: Audit Support

NICE

Alcohol use disorders - clinical management: guideline consultation (17th September 2009)
A clinical practice guideline on Alcohol use disorders – clinical management is being developed for use in the NHS in England, Wales and Northern Ireland. Registered stakeholders for this guideline are invited to comment on the provisional recommendations via this website.

Closing date for consultation is 12th November 2009.
Consultation

Quitting smoking in pregnancy and following childbirth: consultation on the evidence (24th September 2009)
NICE was asked by the Department of Health (DH) to develop guidance on ‘How to stop smoking in pregnancy and following childbirth’.

All registered stakeholders are now invited to comment on the evidence that has been assembled to inform the development of this guidance. This evidence will be used by the Public Health Interventions Advisory Committee (PHIAC) to develop draft recommendations. The evidence comprises a review of effectiveness and barriers and facilitators, three expert reports and a supplementary economic analysis.

Closing date for comments is 22nd October 2009.
Consultation

Extracorporeal albumin dialysis for acute liver failure - Interventional Procedure Guidance IPG316 (23rd September 2009)
Extracorporeal albumin dialysis for acute-on-chronic liver failure involves pumping blood from the body through a thin membrane coated with albumin. Molecules that bind to the albumin membrane are then removed by passing through a charcoal column and an anion exchange, before being reintroduced into the circuit. Both water-soluble toxins (as in renal dialysis) and strongly albumin-bound toxins are removed by this process.

Albumin is purported to have important transport and detoxifications functions, such as the removal of albumin-bound substances, which may ameliorate some of the problems of liver failure.
Guidance

Sunitinib for the treatment of gastrointestinal stromal tumours - Technology Appraisal TA179 (23rd September 2009)
Sunitinib is recommended as a possible treatment for people with unresectable or metastatic malignant gastrointestinal stromal tumours if they have already tried imatinib treatment but it has not worked or was not suitable. The manufacturer of sunitinib has agreed to cover the cost of the drug for the first treatment cycle.

Treatment should be supervised by a specialist who is experienced in treating people with gastrointestinal stromal tumours.
Guidance

Hysteroscopic sterilisation by tubal cannulation and placement of intrafallopian implants - Interventional Procedure Guidance IPG315 (23rd September 2009)
Sterilisation results in the inability to conceive children naturally. It is sometimes chosen as a method of birth control and is usually permanent. In women, hysteroscopic sterilisation by tubal cannulation and placement of intrafallopian implants is used to block the fallopian tubes, with the aim of preventing the eggs from reaching the womb and becoming fertilised. The procedure is performed by passing a small camera and tube (hysteroscope) through the vagina and cervix. A very small implant called a microinsert is placed into each fallopian tube using specialised narrow surgical instruments that are passed through the hysteroscope. The presence of the microinserts causes scar tissue to form in the fallopian tubes, which eventually blocks them.
Guidance

Individually magnetic resonance imaging - designed unicompartmental interpositional implant insertion for osteoarthritis of the knee - Interventional Procedure Guidance IPG317 (23rd September 2009)
Osteoarthritis of the knee can cause pain, stiffness, swelling and difficulty in walking. In this procedure, an individually designed implant is inserted at the knee between the thigh and shin bones with the object of realigning the knee and preventing bone-on-bone rubbing. This aims to reduce pain and delay the progression of osteoarthritis and the need for further, more invasive surgery, such as knee replacement.
Guidance

Pemetrexed for the first-line treatment of non-small-cell lung cancer - Technology Appraisal TA181 (23rd September 2009)
Pemetrexed is recommended as a possible treatment for locally advanced or metastatic non-small-cell lung cancer (NSCLC) if:

• the cancer is a particular type (adenocarcinoma or large-cell carcinoma) and
• the person has not had any treatment for NSCLC before.

Healthcare professionals should not stop prescribing pemetrexed for people who do not have adenocarcinoma or large-cell carcinoma who were already taking it when the guidance was issued. These people should be able to carry on taking pemetrexed until they and their specialist decide that it is the right time to stop treatment.
Guidance

Ustekinumab for the treatment of adults with moderate to severe psoriasis - Technology Appraisal TA180 (23rd September 2009)
Ustekinumab is recommended as a possible treatment for people with plaque psoriasis if:

• standard assessments show that their psoriasis is severe and is affecting their quality of life and
• their psoriasis has not improved with other treatments such as ciclosporin, methotrexate or PUVA (psoralen and long-wave ultraviolet radiation), or they have had side effects with these treatments in the past or there is a medical reason why they should not be given them.

Guidance

Guidance on differences in the uptake of immunisations (including targeted vaccines) in people younger than 19 years - Public Health Guidance PH21 (23rd September 2009)
This guidance is for NHS and other professionals responsible for the immunisation of children and young people. They may work in: children’s services, local authorities, education and the wider public, private, voluntary and community sectors. It may also be of interest to parents.

The guidance aims to increase immunisation uptake among those aged under 19 years from groups where uptake is low. It also aims to ensure babies born to mothers infected with hepatitis B are immunised.
Guidance

Promoting young people's social and emotional wellbeing in secondary education - Public Health Guidance PH20 (23rd September 2009)
This guidance is for all those who have a responsibility for the social and emotional wellbeing of young people in secondary education. This includes teachers, support staff, governors and professionals with public health as part of their remit working in education (including the independent sector), local authorities, the NHS and the wider public, voluntary and community sectors.

It focuses on interventions to support all young people aged 11-19 who attend any education establishment.
Guidance