The National Institute for Health and Clinical Excellence (NICE) has published four new guides to help the National Health Service (NHS) in England commission evidence-based care.

The new tools cover services for faecal incontinence, cardiac rehabilitation, heart failure for the management of chronic heart failure and cognitive behavioural therapy. They follow six guidelines published in January - on memory assessment, hysterectomy, endometrial ablation, female urinary incontinence, intrauterine devices and the intrauterine system for contraception/heavy menstrual bleeding and bariatric surgery – plus updated commissioning tools which were published last year.

Both the updated and new commissioning tools “signpost” and provide topic-specific information on key clinical and service-related issues to consider during the commissioning process, with help in determining the level of service needed locally. They allow commissioners in Strategic Health Authorities (SHA) to log in and view data at Primary Care Trust (PCT) level, while GP practices within a commissioning group/cluster can also give other practices in their cluster permission to view their data and to model commissioning intentions for the group. NICE says it aims to produce up to 10 commissioning guides a year, updated annually.

Clinicians have welcomed the guides which, they say, make the process of developing commissioning pathways far more efficient. “Previously, to get data on my local population, for example referral patterns, I would need to ask local practices or the PCT. The commissioning guides provide the latest Dr Foster data on my area, and also tell me at the beginning of the process what information I need to go away and find,” said Dr Dinah Roy, who chairs the Sedgefield Practice Based Commissioning Group, County Durham PCT.

“Previously I would have to put commissioning model work on hold for three months whilst I gathered together important data. As the key data is available within the commissioning guides, it means I can now focus my time on working with providers to make sure we are delivering a safe and effective service to patients,” added Jon Tuppen, a GP with South West Essex PCT.

Gillian Leng, NICE’s implementation director, said the Institute is now considering how the guides could be improved, and it invites suggestions from individuals involved in commissioning. “NICE is committed to involving end-users in the development of the commissioning guides to ensure they remain fit for purpose,” she said.

PBC commissioning is up, says govt

Meantime, the Department of Health has reported a rise in the number of general practices commissioning new services through Practice-Based Commissioning (PBC). The third quarterly practice survey, published this month, shows an 8% rise in the number of practices doing so since Wave 1 (June-August 2007) and a 5 percentage point rise since Wave 2 (September-November 2007). At Wave 3 (January-March 2008), 41% of practices had commissioned new services through PBC, it says.

The percentage of GP practices which have agreed a commissioning plan with their PCTs is now up to 57%, and 62% now support the policy of PBC. However, 71% practices now claim to have a good relationship with their PCT, which is a three percentage point decline on the figure at at Wave 2.