Evaluating the costs and benefits of implementing adult social care guidelines of the National Institute for Health and Care Excellence (NICE): A scoping study

Introduction

Since 2013 the National Institute for Health and Care Excellence (NICE), the body responsible for providing national guidance in health and social care in England, has produced social care guidelines in addition to clinical and public health guidelines. These guidelines include a set of systematically developed statements (=recommendations) that seek to assist practitioners, managers and commissioners in their decisions about delivering or funding appropriate care and support for specific circumstances. The underlying objective is that implemented recommendations should increase access to good quality care and support that improves outcomes for people who use services and carers, whilst achieving good value for money.

There are about twenty NICE adult social care guidelines covering a range of topics: social care services (e.g. home care), populations (e.g. people with learning disabilities), and aspects of service delivery (e.g. transition between hospital and care homes). Little is known about how these guidelines are implemented in adult social care, or about the impact of guideline implementation on costs and benefits for individuals and organisations. Evidence from the clinical field suggests that many guidelines are not implemented, and that they are more likely to happen successfully when they are aligned with other, related efforts to change practice.

Objectives

This scoping study aims to support the development of further research to evaluate the economic impact of a selected number of implemented adult social care guidelines.

The main aims of this scoping study are to:

1. map NICE’s adult social care guidelines and recommendations
2. summarise key learnings from previous research about implementing guidelines and evaluating them
3. scope some of the guideline implementation activities undertaken locally, and identify potential sites
4. develop a basic conceptual framework describing a ‘Theory of Change’, which sets out how NICE adult social care guidelines might be having an impact in principle
5. explore potential approaches to data collection and analysis for studying the economic impact of guideline implementations.

Methods

The research involves desk-based research, discussions with stakeholders and online workshop(s).