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The Dobson–Rawlins pact and the National Institute for Health and Care Excellence: impact of political independence on scientific and legal accountability

  • Susan McPherson (a1) and Maurice Sunkin (a2)

Abstract

This analysis considers whether the independence of the National Institute for Health and Care Excellence (NICE), while safeguarding guidelines from commercial lobbying, may render NICE legally and scientifically unaccountable. The analysis examines the role of judicial reviews and stakeholder consultations in place of peer review in light of current debates concerning the depression guideline.

Declaration of interest

None.

Copyright

Corresponding author

Correspondence: Dr Susan McPherson, School of Health and Social Care, University of Essex, Colchester CO4 3SQ, UK. Email: smcpher@essex.ac.uk

References

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1Department of Health and Social Care (DHSC), National Institute for Health and Care Excellence (NICE). Framework Agreement Between the Department of Health and Social Care and the National Institute for Health and Care Excellence. DHSC–NICE, 2018 (https://www.nice.org.uk/Media/Default/About/Who-we-are/NICE-framework-agreement.pdf).
2Timmins, N, Rawlins, M, Appleby, J. A Terrible Beauty: A Short History of NICE. Health Intervention and Technology Assessment Program, 2016 (http://www.hitap.net/en/documents/164742).
3Bondy, V, Sunkin, M. The Dynamics of Judicial Review Litigation: The Resolution of Public Law Challenges Before Final Hearing. Public Law Project, 2009 (https://publiclawproject.org.uk/resources/the-dynamics-of-judicial-review-litigation).
4Bondy, V, Platt, L, Sunkin, M. The Value and Effects of Judicial Review: The Nature of Claims, Their Outcomes and Consequences. Public Law Project, 2015 (https://publiclawproject.org.uk/resources/the-value-and-effects-of-judicial-review).
5Syrett, S. Nice and judicial review: enforcing ‘accountability for reasonableness’ through the courts? Med Law Rev 2008; 16: 127–40.
6Fraser & Anor, R (on the Application of) v National Institute for Health and Clinical Excellence & Ors [2009] EWHC 452 (Admin). England and Wales High Court, 2009 (http://www.bailii.org/ew/cases/EWHC/Admin/2009/452.html).
7Rost, F, McPherson, S. Stakeholder Position Statement on the NICE Guideline for Depression in Adults. 2018 (www.nsun.org.uk/news/stakeholder-position-statement-on-the-nice-guideline-for-depression-in-adults).
8National Institute for Health and Care Excellence (NICE). Depression in Adults: Treatment and Management. Consultation Comments and Responses – Second Consultation Period. NICE, 2018 (www.nice.org.uk/guidance/gid-cgwave0725/documents/consultation-comments-and-responses-2).
9Lamb, N. Serious concerns in the #mentalhealth sector that NICE's draft guideline on Depression is not fit for purpose & could have a damaging impact on patient care. @NICEcomms must reconsider! Important cross-party letter with @lucianaberger @Helen_Whately @DrLisaCameronMP & others. 19 July 2018 [cited December 2018]. Available from: https://twitter.com/normanlamb/status/1019955921164828672.
10Csizar, A. Troubled from the start. Nature 2016; 532: 306–8.
11National Institute for Health and Care Excellence (NICE). Developing NICE Guidelines: The Manual. NICE, 2018 (https://www.nice.org.uk/process/pmg20).
12Cleare, A, Pariante, CM, Young, AH. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2008 British Association for Psychopharmacology guidelines. J Psychopharmacol 2015; 29: 459525.
14Servier Laboratories Ltd v National Institute for Health and Clinical Excellence & Anor [2010] EWCA Civ 346. England and Wales High Court, 2010 (http://www.bailii.org/ew/cases/EWCA/Civ/2010/346.html).
15Elliott, MC. Has the Common Law Duty to Give Reasons Come of Age Yet? University of Cambridge Faculty of Law Research Paper 2012; 7: 21 (http://dx.doi.org/10.2139/ssrn.2041362).
16Ioannidis, J. Professional Societies should abstain from authorship of guidelines and disease definition statements. Circulation 2018; 11: e004889.
17Jatoi, I, Shah, S. Clinical practice guidelines and the overuse of health care services: need for reform. Can Med Assoc J 2019; 191: e2978.
18McPherson, S, Beresford, P. Semantics of patient choice: how the UK national guideline for depression silences patients. Disabil Soc 2019; 34: 491–7.

Keywords

The Dobson–Rawlins pact and the National Institute for Health and Care Excellence: impact of political independence on scientific and legal accountability

  • Susan McPherson (a1) and Maurice Sunkin (a2)

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The Dobson–Rawlins pact and the National Institute for Health and Care Excellence: impact of political independence on scientific and legal accountability

  • Susan McPherson (a1) and Maurice Sunkin (a2)
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