National Institute of Health and Clinical Excellence

The National Institute of Health and Clinical Excellence (NICE) website declares its origins and aims from the outset. The initial ‘umbrella’ home page complete with National Health Service (NHS) logo describes NICE as the independent organization responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill-health. Relationships to the NHS and the recent amalgamation with the Health Development Agency (adding the ‘Health’ to the long NICE title) are explained. This new structure is reflected in a division of the site into two main areas, Clinical Excellence and Public Health Excellence. The former is of most interest to occupational physicians. One click further on is the Clinical Excellence home page. Clearly navigable, this signposts separately the ‘business end’ of the site (the growing portfolio of NICE guidelines) and supporting material about the history and process of NICE. The latter includes phenomenal detail about the board, various committees and working partnerships. The credentials of the guideline developers are clear. A generic statement on the site describes the aim to include clinical experts from multiple disciplines for each topic. Moreover, a wide sweep of stakeholders (including patient and carer representatives) is included in the guideline development process. Inevitably, there is a need to reconcile different viewpoints and agendas. However, the mechanism for this is transparent. Conflicts of interest are carefully addressed for each Guideline Development Group, and are made explicit to the public on the website. The guidelines themselves are extremely useful tools. In truth, some are not very relevant to occupational physicians but others including those on depression, anxiety and back pain are essential reading. The Public Health Excellence area is less useful to occupational physicians, but there is some relevant guidance on health promotion issues such as smoking cessation policies and physical activity. The material on the NICE website is unbiased and frighteningly up to date. A ‘New Developments’ tab on the Clinical Excellence home page puts important news in the forefront of the user's attention. Overall, the design is excellent, being streamlined and stratified to allow detail where required or a quick overview when detail is not necessary. The Freedom of Information Act is mentioned in detail, with instructions on how to make an application. The website has a feedback page, and it appears that user opinion is taken into account. A pending revision to the site aims to streamline access to the guidelines themselves (via a single click from the home page), although they are very easy to find even in the current format. Users are not required to register, and no charge is made. NICE guidelines can be downloaded free. Without a doubt, the NICE website is exemplary. Its design is first class and the content is high quality. The usefulness to occupational physicians is not uniform. However, the main asset of the site—a set of evidence-based and expert clinical guidelines is a valuable tool if used selectively. Access 5 Speed of searches 4 User friendliness 5 Links to other websites 3 Overall 5 Should be ‘bookmarked’ (added to favourites)