1st Edition

NICE at 25 A quarter-century of evidence, values, and innovation in health

Edited By Peter Littlejohns, Keith Syrett Copyright 2025
222 Pages 3 B/W Illustrations
by Routledge

222 Pages 3 B/W Illustrations
by Routledge

222 Pages 3 B/W Illustrations
by Routledge

Marking its 25th anniversary, this fascinating collection examines the pioneering work of the National Institute for Health and Care Excellence (NICE). Setting standards for the delivery of healthcare, issuing guidance on public health, and assessing and making recommendations on health technologies, NICE has attracted widespread international attention, emulation, and comment. The authors in... Read more

Foreword                              The Rt Hon. the Lord Darzi of Denham

Preface                                  Peter Littlejohns and Keith Syrett

Acknowledgements

Chapter 1      Introduction: Why NICE and why the book?

                        Peter Littlejohns and Keith Syrett

Chapter 2      NICE and resource allocation in the NHS: paradise lost?

                        Karl Claxton, Mark Sculpher and Anthony J. Culyer

Chapter 3      Understanding the survival of NICE through a political science lens

                        David J. Hunter and Peter Littlejohns

Chapter 4      NICE’s paradigm of public practical reasoning

                        Albert Weale

Chapter 5      Innovation, values and NICE’s changing societal role

                        Victoria Charlton

Chapter 6      Do NICE’s HTA processes still lead to net improvements in NHS services?

                        James Wilson

Chapter 7      Public Health at NICE: Methods, politics and policy

                        Michael P. Kelly

Chapter 8      Public involvement at NICE: Evolution, not revolution

                        Sophie Staniszewska and Sophie Söderholm Werkö

Chapter 9      NICE and the law: Judicial oversight, juridification and legitimacy?

                        Keith Syrett

Chapter 10   Enhancing the value of public spending on health technology around the world

Ryan Jonathan Sitanggang, Kinanti Khansa Chavarina, Kalipso Chalkidou, Fiona Pearce and Yot Teerawattananon

Chapter 11    Conclusion: NICE from the past into the future

                        Peter Littlejohns, David J. Hunter and Keith Syrett

Biography

Peter Littlejohns is Emeritus Professor of Public Health at King’s College London, and the founding Clinical and Public Health Director of NICE. He has led on a number of international research programmes addressing ways of improving the effectiveness and efficiency of health services through fair prioritisation policies.

Keith Syrett is Professor of Health Law and Policy and Director of the Centre for Health, Law, and Society in the School of Law, University of Bristol, UK. He has written extensively on the legal regulation of resource allocation in healthcare, health technology assessment, and public health law.

"NICE is the institutional embodiment of a task all health systems must grapple with; how to ration. As this excellent collection of economic, sociological, philosophical, legal, international and political perspectives on its evolving work over the last 25 years makes clear, that task has not been easy or without controversy. Like Zeno’s arrow, NICE may never reach its target, but as this book attests, it has to keep on its journey".

Professor John ApplebySenior Associate, Nuffield Trust, UK.

"The future of healthcare faces many profound challenges, not least the need to balance ever-expanding demand with restricted resource. NICE was designed to bring rationality to this dilemma and has always relied on using high quality evidence in its work. It is highly appropriate that a challenging and questioning approach to reviewing the evidence for NICE’s impact is central to this important, thoughtful, and informative book".

Sir David Haslam, CBE, FRCP, FRCGPChair of NICE, 2013-2019.

"NICE has an important place in the architecture of the UK’s healthcare. Against a background of regular upheavals in the NHS - in leadership, funding, and, critically, political ideology - NICE has survived to enjoy its 25th birthday. But the celebrations, to this writer, are muted. NICE has changed. In a serious, rigorous and careful manner, this book explores not just the ever-present philosophical  challenges its approach entails, but, in its need to command legitimacy, the more concerning move towards the accommodation of government and industry in its decisions".

Professor Sir Ian KennedyEmeritus Professor of Health Law, Ethics and Policy, University College London, UK.

"No other set of authors could have deployed such a rich combination of insiders’ experience and academic rigor to give the reader a unique insight into what has made NICE tick; the great successes, the errant efforts; the hopes realized and dreams yet unfulfilled.  This book will be a landmark in our understanding of the past, and a roadmap to more effective and equitable health care systems of the future".

Steven Pearson, MD, MSc, FRCP, President of the Institute for Clinical and Economic Review, USA.

"The work of NICE has had a life span of 25 years – one of the longest running arm’s length bodies. What is the secret of its longevity and place in our healthcare system is uniquely explored by the authors of this book. There is recognition the future path maybe even more bumpy than the journey to date. A must read for all those that want to see Value-Based Healthcare."

Professor Maggie Rae CBE, FFPH, FRCP (Hon), FRCP Edin, FRCPath (Hon), FFSRH (Hon), FFOM (Hon), FRSPH. Visiting Professor at Exeter University and University of the West of England