What are the costs and consequences of implementing NICE adult social care guidelines from a local systems perspective?

Introduction

The National Institute for Health and Care Excellence (NICE) was established in 1999 to develop guidelines for the National Health Service, and these have had many impacts on the treatments and services that are available across the country. Since 2013, NICE has also been responsible for developing social care guidelines in England. These guidelines contain recommendations for people working in adult social care to help them understand what services and support arrangements are likely to lead to better outcomes for people with social care needs and carers, and what services offer good value for money. It is expected that these guidelines will help to improve access to high-quality social care and so also improve the wellbeing and health of people with social care needs and also of carers.

Despite the substantial investment in guideline development, very little is known about how guidelines are used by people who make funding decisions or deliver adult social care. It is not known what kind of resources are needed to put guidelines into practice (i.e., to implement guidelines), nor is it known whether they do actually lead to improved outcomes for individuals with social care needs or their carers. This kind of knowledge is important to understand how best to develop and implement guidelines and to encourage their use more widely.

This research will explore the potential costs and consequences (including outcomes for individuals with social care needs and carers) of implementing NICE adult social care guidelines. The project will work in a small number of local areas spread across the country. In those localities, the project will look at single or groups of providers and commissioners (the organisations that fund the services – usually these are local authorities) in the social care and healthcare sectors. (Some social care guidelines include recommendations for the NHS.) These providers and commissioners have either already implemented recommendations from one or several NICE adult social care guidelines, or are implementing them now, or are planning to implement them soon.

The project team will work closely with key individuals in those localities to work out how to assess the resources (budgets and staff, for example) that go into implementing guideline recommendations, as well as the expected impacts on people with social care needs and carers. Using a method called simulation modelling, data that is already available on resource use and outcomes, or new data collected, will be used to estimate the likely costs and consequences of implementing recommendations from NICE in the adult social care area.

The research team will work closely with local and national stakeholders – including people with social care needs, carers and social care practitioners – throughout the research.
Working together will develop recommendations for NICE social care guidelines into practice and for future research.