Greater implementation of the UK’s National Institute for Health and Clinical Excellence guidance will only be achieved if financial management by hospitals and primary care trusts improves, according to a national report published today by the country’s Audit Commission.

NICE is the UK’s cost-effectiveness body and makes recommendations to individual NHS bodies across the country about whether specific drugs or treatments, typically those with higher costs, should be used. However, many NHS bodies involved in the Commission's research perceived cost to be the major barrier to implementation.

James Strachan, Chairman of the Audit Commission, said: “NICE plays a major role in ensuring high-quality patient care across the NHS which is both equitable and good value for the taxpayer. But NICE guidance is not being systematically implemented across the country. There will always be competing priorities for funding, but surprisingly our report shows that it is not actually cost which is the root of the problem. What would make all the difference, and is readily achievable, is improved financial planning and better communication between finance and clinical staff.”

The report identifies a number of weaknesses in financial management arrangements that are hindering implementation, including: a lack of financial planning for the implementation of NICE guidance; insufficient communication between finance and clinical staff; the omission of NICE guidance costs in financial plans; and uncertainty about the implications of Payment by Results for the funding of NICE guidance locally.

If appropriate planning, costing, budgeting and monitoring processes are not put in place, the Audit Commission warns that it is unlikely that NICE guidance will be systematically implemented and that postcode prescribing will continue.

Andrea Sutcliffe, NICE Deputy Chief Executive, said: “NICE already provides costing templates to support the NHS and is currently preparing a guide on how to implement NICE guidance successfully across the NHS, which also highlights the importance of good financial management.”