Next Set Of NICE Quality Standards Launched On Depression, Diabetes And Glaucoma

NICE has today (31 March) launched new quality standards on depression in adults, diabetes in adults and glaucoma 1, adding to the library of standards already published2.


NICE quality standards are markers of excellence in patient care. They are aimed at patients and the public, health and social care professionals, commissioners and service providers, and are developed in partnership with NHS and social care professionals, along with their affiliates and service users. They are the only health and social care standards that apply nationwide, right across the NHS in England.


Based on the best available evidence, usually NICE guidance or other NHS Evidence accredited sources, NICE quality standards will form a cornerstone of the new NHS Outcomes Framework3, which sets out the aims and objectives towards improving outcomes in the NHS, and what this will mean for patients and healthcare professionals.


Depression currently affects about one in six people in the UK at some stage in their lives, and is more common in women4. It may have no obvious cause, or it can be triggered by physical illness or difficult things that have happened in the past or may be happening now, like bereavement, family problems or unemployment.


The quality standard on depression identifies 13 statements that define high quality care. These include ensuring that people who may have depression receive an assessment that identifies the severity of symptoms, the degree of associated functional impairment and the duration of the episode. In addition, people with depression that has not responded adequately to initial treatment within six to eight weeks have their treatment plan reviewed. It also states that practitioners delivering pharmacological, psychological or psychosocial interventions for people with depression receive regular supervision that ensures they are competent in delivering interventions of appropriate content and duration in accordance with NICE guidance.


Diabetes is an increasingly common health condition in the UK: about 2.8 million people have type 1 or type 2 diabetes5. Common symptoms in both types of diabetes are increased thirst, passing water frequently (especially at night), tiredness and weight loss.


The quality standard on diabetes in adults defines excellent care in 13 statements that include providing people with personalised advice on nutrition and physical activity from an appropriately trained healthcare professional or as part of a structured educational programme. People with diabetes should also receive an annual assessment for the risk and presence of the complications of diabetes which are managed appropriately. The quality standard also states that people with diabetes with or at risk of foot ulceration receive regular review by a foot protection team in accordance with NICE guidance, and those with a foot problem requiring urgent medical attention are referred to and treated by a multidisciplinary foot care team within 24 hours.















Glaucoma is a common health problem, affecting about one in 50 people aged over 40. This rises to about one in 10 people over the age of 75. It is unusual in people under the age of 35, and becomes more common with age6.


The quality standard on glaucoma consists of 12 statements, including that people diagnosed with chronic open angle glaucoma (COAG)7, suspected COAG or with ocular hypertension (OHT)8 are monitored at intervals according to their risk of progressive loss of vision in accordance with NICE guidance. People diagnosed with COAG, suspected COAG or with OHT should also have access to timely follow up appointments and specialist investigations at intervals in accordance with NICE guidance.


Dr Fergus Macbeth, Director of the Centre for Clinical Practice at NICE said: "We are very pleased to be publishing this next tranche of quality standards, and we are confident they will help local NHS healthcare professionals to provide the best care possible to their patients. These standards have been developed using a number of high quality evidence sources from NICE, The Royal College of Physicians, The Royal College of Psychiatrists, NHS Diabetes, The College of Optometrists and The Royal College of Ophthalmologists."


Professor Dinesh Bhugra, President of The Royal College of Psychiatrists, said: "This new standard on depression is welcomed by The Royal College of Psychiatrists, and we are very pleased to have been part of its development. 1 in 5 people will suffer an episode of clinical depression at some point in their lifetime. It is therefore very important that there are appropriate standards in place for all those healthcare professionals who are involved in treating people with depression."


Anna Morton, Director of NHS Diabetes said: "Diabetes is such a major public health problem, it is important that there are clear standards in place that will help those involved in the care of people with this serious condition. I am sure the standard will be welcomed by both patients and healthcare professionals alike."


Winfried Amoaku, Acting President of The Royal College of Ophthalmologists said: "The Royal College of Ophthalmologists welcomes the publication of this quality standard on glaucoma. It is important, for patients to know what level of care to expect, and for healthcare professionals to know what works in delivering excellent, cost-effective care for patients."


Notes


1. The quality standards on depression, diabetes and glaucoma are available on the NICE website from Thursday 31 March here.


2. The NHS Outcomes Framework can be found here.


3. Quality standard topics are referred to NICE by ministers on the advice of the National Quality Board, a group of representatives from health and social care, committed to improving quality in the NHS and overseeing the reforms aimed at improving care.


References


1. Glaucoma is a group of eye conditions in which the pressure inside the eye becomes too high. This results in damage to the optic nerve at the back of the eye, which can lead to loss of vision if left untreated.


2. Quality standards have already been published by NICE on chronic kidney disease, dementia, specialist neonatal care, stroke and venous thromboembolism (VTE) prevention.


3. The recently announced Transparency in Outcomes framework for the NHS proposes using quality standards to produce more detailed commissioning guidance to meet the suggested outcome goals.


4. Office of National Statistics.


5. Diabetes UK.


6. patient.co.uk


7. COAG is the most common form of glaucoma and develops gradually.


8. OHT is defined as consistently elevated pressure in one or both eyes and is a major risk factor for glaucoma.