NICE Guidelines Disclaimer

[JohnM]

Just by way of a quick intro ..

As most on PR will have noted, NICE have undertaken a surveillance review of the guidelines as applied to our disease. Following on from the IiME consultation response to the review, I noted the following:

"Going forward then any harm coming to patients by these guidelines and from any decision not to update them must be seen to be caused by the NICE Board and SMT and accountability must be taken by those members." (p5)

This coupled with some comments on other threads asking whether or not guidelines for other health conditions were as appalling as our own. I decided to have a look at the full guidelines for MS (CG186 - Multiple sclerosis, Management of multiple sclerosis in primary and secondary care, last updated Oct 2014).

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I found the following disclaimer statements within the CG186 document:

"Healthcare professionals are expected to take NICE clinical guidelines fully into account when
exercising their clinical judgement. However, the guidance does not override the responsibility of
healthcare professionals to make decisions appropriate to the circumstances of each patient, in
consultation with the patient and/or their guardian or carer." (p3)

and

"Health care providers need to use clinical judgement, knowledge and expertise when deciding
whether it is appropriate to apply guidelines. The recommendations cited here are a guide and may
not be appropriate for use in all situations. The decision to adopt any of the recommendations cited
here must be made by practitioners in light of individual patient circumstances, the wishes of the
patient, clinical expertise and resources.

The National Clinical Guideline Centre disclaims any responsibility for damages arising out of the use
or non-use of this guideline and the literature used in support of this guideline." (p35)

When I commented on another thread that UK healthcare is 'byzantine', little did I know. So in light of this, are NICE by extension, able to invoke this same disclaimer? A horrifying thought if so, given all the implications that would entail.

Just hoping that this is an over-reaction on my part, not wanting to add any undue worries, and seeing things that aren't there.

Note:
The National Guideline Centre (NGC) is a multi-disciplinary health services research team funded by the National Institute for Health and Care Excellence (NICE). We produce evidence based clinical practice guidelines on behalf of NICE. Our guidelines aim to improve the quality of patient care within the NHS in England and Wales.

Wishing everyone improved health and every happiness. John

 

[Demepivo]

You do have to love how everybody in the CBT/GET/PACE/NICE industrial complex likes passing the buck

 

[trishrhymes]

So what they are saying is, in essence, it's down to your doctor. If they follow the guidelines and you get worse, it's the doctors fault, and if they don't follow the guidelines and you get worse, it's the doctors fault. So what's the point of NICE?

 

[slysaint]

So what they are saying is, in essence, it's down to your doctor. If they follow the guidelines and you get worse, it's the doctors fault, and if they don't follow the guidelines and you get worse, it's the doctors fault. So what's the point of NICE?

So does this apply down the line to the actual therapists? If so their argument would then just be that they were not administering the therapy correctly and just need extra training.
So no accountability at all.

 

[Valentijn]

The National Clinical Guideline Centre disclaims any responsibility for damages arising out of the use or non-use of this guideline and the literature used in support of this guideline.

Disclaiming responsibility doesn't make it so, even legally. If NICE deliberately or negligently misleads doctors in their pursuit of the cheapest way to fob off patients, they are still accountable.

 

[JohnM]

So does this apply down the line to the actual therapists? If so their argument would then just be that they were not administering the therapy correctly and just need extra training.
So no accountability at all.

Perhaps to therapists working within an NHS setting, not sure about private clinics?

Happen that is why they developed a whole new CBT/GET approach just for us, and continue to re-label and tweek their psychosocial therapy of choice.

Healthcare it ain't, a 'marketing health strategy' it is, and coming to patients with other chronic health issues real soon, if they get their way.

Disclaiming responsibility doesn't make it so, even legally. If NICE deliberately or negligently misleads doctors in their pursuit of the cheapest way to fob off patients, they are still accountable.

Can only agree on your first point, but perhaps I need to change thread of title to clarify the differences between disclaimers for NICE and the NGC(NGCG)? Any thoughts kindly appreciated.

On your second point, it should be noted that "The work of the NGC (who are responsible for NGCG) is overseen by a governance partnership between the Royal Colleges of General Practitioners, Nursing, Physicians and Surgeons. Each college is represented on the NGC management board, alongside representatives from the Royal College of Physicians Patient and Carer Network, the UK Cochrane Centre, and NHS England."

So it would seem that it is the 'leaders' of GP's, Nurses, Physicians and Surgeons who are also "deliberately or negligently misleading' their respective healthcare professionals, and seek to avoid any and all responsibility for their actions. As mentioned in another thread .. a very 'Donald Trump' approach to responsibility and accountabilty.

Apologies in advance if any further confusion caused, I know this 'byzantine' level of complicity is sure confusing me.

Wishing everyone improved health, and every happiness. John

 

[Valentijn]

Can only agree on your first point, but perhaps I need to change thread of title to clarify the differences between disclaimers for NICE and the NGC(NGCG)? Any thoughts kindly appreciated.

Organizations and individuals can't make themselves free of liability, basically. Only the law can do that. So saying "I'm not liable" means absolutely nothing, unless it's backed up by something, such a law that covers the topic, or applicable case law.

And even then, it's usually open to debate