Six years of NICE International

To date NICE International has delivered hands-on technical projects in 35 countries

NICE International contributes to better health around the world through the more effective and equitable use of resources. It does this by providing advice on the use of evidence and social values in making clinical and
policy decisions.

NICE International celebrated its sixth birthday in 2014. Over the past year, we have had the privilege of reinforcing our partnership with the Chinese Health and National Planning Commission’s new administration and have signed a bilateral agreement with the leadership of the Indian Ministry of Health and Family Welfare, looking forward to working with the new Indian administration in its ambitious plans to achieve Universal Healthcare Coverage.

In the past 12 months we have also strengthened our engagement with the Vietnamese authorities, at the request of the country’s Minister of Health. Throughout 2013, NICE International’s team was active in Ecuador, Afghanistan, South Africa, Ghana, the Philippines and Kazakhstan. In parallel to our country engagements, we have strengthened our partnership with major donors and multilaterals, such as the Rockefeller Foundation and the UK’s Department for International Development, and with the new leadership of the World Bank. NICE International and all three organisations above are explicitly committed to Universal Healthcare Coverage.

Working together with long term friends and partners such as the Thai Health Intervention and Technology Assessment Programme (HITAP), the Washington-based Center for Global Development (CGD) and major academic players such as the University of York, Glasgow University and the National University of Singapore, we look forward to further strengthening our evolving global network so we can respond to the growing demand for technical cooperation aimed at making global resource allocation decisions more evidence based, more efficient and fairer.

To date, NICE International has delivered hands-on technical projects in 35 countries, helping build capacity, adapt good quality international guidelines to the local setting using local data, develop clinical pathways and performance standards, carry out cost-benefit evaluations of interventions and technologies and boost governance and transparency in decision making. In a further 42 countries, NICE International has engaged with policy makers and formed partnerships, many of which are active today.

Most importantly, 2013 was the year we received our inaugural grant from the Bill & Melinda Gates Foundation, in what we hope will be the beginning of a long partnership with a view to strengthening evidence-based decision making in developing countries and also amongst donor agencies. As a result of Gates and DFID funding we launched the international Decision Support Initiative - a sustainable and scalable approach to decision support globally.

The same year, the Methods for Economic Evaluation Project (MEEP) was initiated with funding by the Bill & Melinda Gates Foundation to improve the quality and transparency of economic evaluation and to guide researchers in undertaking and reporting economic analyses useful to policy makers. 

Case study: Developing quality standards for Vietnam

Using a Rockefeller Foundation grant, NICE International has been supporting the Ministry of Health, in partnership with the Vietnam Health Economics Association (VHEA), in developing a comprehensive national quality strategy through evidence-informed quality standards in high priority chronic diseases.

This work contributes to Vietnam’s 2012 – 2016 health strategy to improve care quality across different tiers of hospitals and marks the start of a long-term partnership with Vietnam. NICE International has also been helping the Ministry of Health review the way it maintains and adjusts its basic package of services in the context of Universal Healthcare Coverage.

Following a scoping visit in December 2012 at the invitation of the Minister of Health, NICE International conducted a mapping exercise in conjunction with VHEA and the MoH to identify key policy priorities where NICE International can add value. This process identified the need for defined, transparent and evidence informed processes to determine the basic package, that is, what services should be available to people and when. In particular, stroke is one of the major causes of death in the country and was identified as a specific priority for improving care delivery and outcomes by implementing evidence based quality standards. The mapping was combined with a multi-stakeholder training workshop in Hanoi in May 2013, on health technology assessments, clinical guidelines, quality standards and indicators and how they can be linked to professional education, regulation and payment in the context of the healthcare system.

In July 2013, a senior delegation, led by the Vice Minister for Health, Madame Xuyen and funded by the Joint Learning Fund (JLF) spent five days with NICE International to help inform the Ministry’s strategy for quality improvement. The group learnt about the structure of the NHS, NICE’s health technology assessment processes, the development and implementation of NICE clinical guidelines and quality standards including pay for performance schemes, and the role and structure of primary care in the UK. They visited the Health and Social Care Information Centre in Leeds and the stroke unit at St Thomas’ hospital in London. Summarising her experience of the study tour Madame Xuyen said: ‘This is one of the best trips I have ever participated in. I have learned a lot from UK’s health care system. On behalf of delegation, I would like to thank you so much for the strong support’.

With NICE International’s assistance, our Vietnamese partners recruited a committee for the development of Vietnamese quality standards, comprising stroke doctors and nurses from different regions and hospital tiers from across the country. The committee convened a workshop in November 2013 co-chaired by Prof Le Duc Hinh (President of the Vietnam Association of Neurology) and Professor Anthony Rudd CBE (National Clinical Director for Stroke, NHS England). The workshop produced a shortlist of locally relevant clinical recommendations using international and UK evidence adapted to the local context under the guidance of the local experts. Two further workshops are scheduled for 2014 to develop these recommendations into measureable indicators, and the plan is to implement the quality standards in selected hospitals across the country, through potential regulatory and payment reforms and with World Bank support.

In November 2013, NICE International also completed the first phase of its review of the process for deriving the country’s basic package. This included interviews and group discussions to outline current mechanisms for basic package design, and a training event at Hanoi Medical University the use of Health Technology Assessment for making policy decisions the latter driven by our Thai counterparts, HITAP.