Should NICE's advice be handled centrally or locally?

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7286.613 (Published 10 March 2001) Cite this as: BMJ 2001;322:613
  1. Peter Brambleby (peter.brambleby@norfolk.nhs.uk), consultant in public health
  1. Norfolk Health Authority, Thorpe St Andrew, Norwich NR7 0HT

    EDITOR—Smith's editorial on the failings of the National Institute for Clinical Excellence (NICE) addresses the right issue but attacks the wrong target.1 It is not the recommendations emanating from the institute's deliberations that have an impact on the NHS but the subsequent executive letter that issues from the Department of Health.

    The institute has many strengths, but its remit is weak in at least four areas2:

    • It often has to rely on evidence from studies whose criteria on patient selection exclude people at the extremes of age, non-compliant people, …

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