Making decisions using NICE guidelines

People have the right to be able to make informed decisions about their care. Our guidance should be taken into account when making decisions with them.

We're working with other leading health organisations to encourage shared decision making between the people receiving and delivering care.

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Shared decision making

Shared decision making is a joint process in which a healthcare professional works together with a person to reach a decision about care.

It involves choosing tests and treatments based both on evidence and on the person's individual preferences, beliefs and values.

Prescribing medicines

When we recommend medicines we expect that healthcare professionals will prescribe or advise their use within the terms of their UK marketing authorisations, as described in manufacturers' summaries of product characteristics (SPCs). SPCs for most medicines are listed in the electronic medicines compendium.

Healthcare professionals should take note of the contraindications, warnings, safety recommendations and any monitoring requirements for the medicine. These are explained in the SPC for the medicine, the British National Formulary (BNF) or British National Formulary for Children (BNFC).

Off-label or unlicensed use

Sometimes we recommend a medicine for a particular condition or patient group when this is not within the medicine's marketing authorisation. This may include using the medicine by a route that is not within the marketing authorisation. This is known as ‘off-label’ or ‘unlicensed’ use.

We do this only if there is enough evidence or experience to support. We make it clear in our guidance when we do so. Healthcare professionals should follow relevant professional guidance. They should take full responsibility for the decision when prescribing or advising the use of off-label or unlicensed medicines. This includes considering the contraindications, warnings, monitoring requirements and other safety recommendations for the medicine.

You can find more information on this at:

Using recommendations

Our recommendations are based on:

  • the trade-off between the benefits and harms of an intervention

  • the quality of the underpinning evidence.

Some recommendations are made with more certainty than others. We word our recommendations to reflect this. Where there is clear and strong evidence of benefit, we will use the word 'offer'. Where the benefit is less certain we use the word 'consider'.

For more information take a look at developing NICE guidelines: the manual.

Safeguarding

The government has produced statutory guidance that must be followed. This is in both adult safeguarding and the safeguarding of children and young people.

Remember that abuse and neglect:

  • is common

  • may also exist alongside other health problems or social care needs

  • can happen anywhere, including in emergency departments and primary care.

Consider or suspect abuse as a contributory factor or cause of an injury in adults or children at risk.

Our guidance and quality standards on safeguarding will provide you with more information.

There are laws and professional standards that should be followed when making decisions. We have compiled a list of organisations and key information which may help you.