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Setting standards in antenatal care. Jane Thomas Director NCC-WCH Hon consultant Obstetrics and gynaecology, Oxford 30.April 2003. Overview. NCC-WCH National Standards ANC Children’s National Service Framework National screening committee NICE Technology appraisals

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setting standards in antenatal care

Setting standards in antenatal care

Jane Thomas

Director NCC-WCH

Hon consultant Obstetrics and gynaecology, Oxford

30.April 2003

overview
Overview
  • NCC-WCH
  • National Standards ANC
    • Children’s National Service Framework
    • National screening committee
    • NICE
      • Technology appraisals
      • Clinical guidelines
  • Clinical Guidelines
  • ANC guidelines
ncc wch
NCC-WCH

Funded to produce

guidelines and audit for the NHS by NICE

RCOG Evidence Based Clinical Guidelines

RCOG Manchester Audit Unit

RCOG CESU

Consumer

RCOG, RCM, RCPCH, FFPRHC, AGUM, MSSVD

2002

HSR

ncc wch guidelines
NCC-WCH guidelines

Publication

  • Antenatal Care Oct ‘03
  • InfertilityNov ‘03
  • Caesarean sectionMar ’04
  • Type 1 Diabetes in childrenFeb ‘04
  • Long acting reversible contraceptionDec 04
national standards for anc
National standards for ANC
  • National screening committee
  • National Service Framework
  • NICE
    • Technology appraisals
    • Clinical guidelines National Service Framework
national standards for anc6
National standards for ANC
  • National screening committee
  • National Service Framework
  • NICE
    • Technology appraisals
    • Clinical guidelines National Service Framework
first class service 1998

Continued Professional Development

Clinical Governance

Lifelong Learning

First Class Service 1998

National service frame works

National Standards

NICE

Local

CHI

National Monitoring

National Collaborating Centre for

Women’s and Children’s Health

national standards for anc8
National standards for ANC
  • National Service Framework
  • National screening committee
  • NICE
    • Technology appraisals
    • Clinical guidelines
nice ta and guidelines
NICE TA and guidelines
  • NHS clinical guidance based on
    • Clinical effectiveness
    • Cost effectiveness
  • Products
    • Clinical guideline (⇒Collaborating Centres)
    • Technology appraisals
what are clinical guidelines
What are clinical guidelines?

“systematically developed statements to assist practitioner and patient decision about appropriate health care

for specific clinical circumstances’

National Institute of Medicine 1992

aim of guidelines
improve quality + consistency + outcome of care

promote effective interventions + discourage ineffective interventions

make efficient use of resources

highlight clinical need/service provision

highlight gaps in research

reassure clinicians and patients

Aim of guidelines
slide13

Key components for guideline validity

1. multi-disciplinary working groups

2. systematic review

3. explicit link of evidence to recommendations

4. explicit methods

nice guideline development process
NICE guideline development process

Time

months

DH remit

Scope

6

Submit

Evidence

GDG

Develop questions

4. Apply evidence

NCC-WCH

  • Systematic review
  • Evidence appraisal

12-18

1st Draft

Final Draft

6

Stakeholder comment

GUIDELINE

dh remit anc
DH remit ANC
  • " …NHS in England and Wales
  • routine antenatal care for all women including the number and timing of antenatal visits required and evidence based justification for the scope and content of each.
  • draw upon the evidence based recommendations of the antenatal subgroup of the National Screening Committee".
anc scope
ANC scope
  • Populations
    • baseline care of all pregnancies.
    • Comprehensive advice on the antenatal care of the healthy woman with an uncomplicated singleton pregnancy
  • Settings- all NHS
anc scope18
ANC scope
  • guidance on antenatal visits
  • antenatal screening
  • educational aspects of antenatal care that are relevant to the antenatal health of the woman.
  • communication issues that influence the ability of women to make informed decisions
anc scope what s excluded
ANC scope-what’s excluded
  • The investigation and management of complications arising in pregnancy
  • Any aspect of intrapartum and postpartum care
anc guideline group
ANC guideline group

GDG:

Group leader: Peter Brocklehurst

2 midwives

2 GP’s

2 obstetricians

a paediatrian

a radiolographer

2 consumer representatives

NCC-WCH methodological support

1st GDG meeting June 02

1st Draft consultation: Apr 03

Publication: Oct 03

timetable anc
Timetable ANC
  • 1st GDG meeting June 02
  • 1st draft consultation: 14 Apr-11 May
  • 2nd draft consultation: 16 Jun-11 July
  • Publication: 23rd Oct 2003
guidelines and nice ta
Guidelines and NICE TA
  • Guidelines incorporate NICE’s TA recommendations,
    • Rhesus anti D prophylaxis.
guideline nsf
Guideline + NSF
  • Complement the recommendations of the NSF.
  • It will support the implementation of the NSF.
nice guidelines
NICE guidelines
  • 3 formats
    • Full
    • NICE short form
    • Patient version
  • Audit standards  CHAI
  • Research recommendations
slide27
Up to date information about the NCC-WCH and guidelines is available from

http://www.nice.org.uk/

Thank you

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