National Institute for Health and Clinical Excellence at Health Select Committee

On Tuesday 2 September 2014, the Health Select Committee, of which Valerie is a member, heard evidence from Professor David Haslam and Sir Andrew Dillon, the Chair and the Chief Executive respectively of the National Institute for Health and Clinical Excellence (NICE).

Valerie said:

“I asked Sir Andrew Dillon what the value of NICE’s quality-adjusted life year (QALY) is, and whether this is different under the burden of illness than the wider societal impact. A QALY is worth in the range of £20,000 and £30,000, but amendments to NICE guidelines can provide a maximum weighting of 2.5 to increase a QALY to £50,000 for end of life treatments. It is no longer the case that a QALY is a QALY is a QALY. The NHS has a fixed budget so if the value of a QALY is increased this leads to a displacement of services in other areas of the NHS. The wider societal impact of a QALY includes age. In my view this could discriminate against people who are older and have lesser value in terms of their impact in society. Sir Andrew Dillon agreed with these points and said that NICE cannot avoid recognising the impact of the point at which you are in your life.”

“I asked for definitions of clinical guidance and quality standards in an accessible manner for the members of the public. I was told that a clinical guideline is a document that ‘shows the important decision points in the sequence of treatment or care that somebody needs to get the best possible outcome for whatever problem they have, whether it is a disease or condition’. Quality standards are markers of good practice that need to be in place in order for the patient to be confident that the service in total is in place to give them the best outcomes. As a result of the Francis Report, NICE is acting to identify excellent practice and the very best that the NHS could be doing.”

“ I was pleased that Professor Haslam responded that NICE pathways explain NICE’s guidance and information to the public in a simple flow diagram on their website. This includes each stage of treatment for a large range of conditions, while also providing more detail on each step in a manner that is accessible.”

For more information about the Health Select Committee please click here.