Introduction

The National Institute for Clinical Excellence (NICE) was set up as a special health authority for England and Wales in 1999. Its role is to provide patients, health professionals, and the public with authoritative, robust, and reliable guidance on current “best practice.” It has three main functions: to appraise new technologies, to produce or approve guidelines, and to encourage improvement in quality. NICE was first announced in the new Labour government's white paper The New NHS.1 As a special health authority it is part of the Department of Health. NICE marks an innovation internationally in that while some other countries have bodies to provide advice on which new health technologies to use, NICE is the first national body with power to issue guidance covering the full range of health technologies.2 Guidance from NICE applies to the NHS in the same way as guidance from other parts of the Department of Health; while health authorities are required by statute to take account of but not necessarily follow guidance, general practitioners have greater discretion.3