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The National Institute for Clinical Excellence (NICE) does not
currently fulfil its promise to give guidance on interventions of
uncertain value and provide clinical guidelines and clinical audit
packages. This is because there is ambiguity about how NICE reaches its
conclusions and uncertainty about the impact of guidance on the NHS and
about who monitors compliance. As a result, NICE's impact is uncertain
and geographical inequity in the provision of health services is likely
to persist. Dent and Sadler (p 842) consider what NICE needs to succeed
and how its chances could be improved. They conclude that there needs
to be wider debate about criteria, clarity on status, and more concise
recommendations about clinical audit methods.