National Institute for Health and Care Excellence

The National Institute for Health and Care Excellence (NICE) is a UK government body that approves treatments for use within the UK National Health Service (NHS) with the mission to improve health and social care through evidence-based guidance.

Online tools

• NICE Pathways – Mapping our guidance
• Find guidance
• Standards and Indicators
• Evidence Search

Media coverage

NICE is involved in a wide variety of treatments for many health and social issues. The Guardian has a collection of articles here.

CFS/ME treatment guidelines

NICE guidelines recommend Graded exercise therapy (GET) and Cognitive behavioral therapy (CBT) as treatments for CFS/ME patients.

Review, remove or revise NICE guidelines

Patients and patient advocacy groups are not in favor of the NICE guidelines and on June 25th 2014 the Forward-ME Group met with Prof Mark Baker, Director of the Centre for Clinical Practice at the National Institute for Health and Clinical Excellence (NICE)]. Professor Baker that the ME/CFS Guideline did not meet patient needs nor those of NICE. He said the Guideline did not promote innovation and only a "passive" intervention such as CBT and Graded Exercise. "There was not much of an evidence base to go on, and in NICE it was evidence that drove guidance."

Margaret Williams noted: "Research that directly impinges on the safety of the NICE recommendations for graded exercise (which was available to the GDG) was also excluded from consideration and / or ignored. This was a serious omission." The recommendation of GET should be incrementally increased to Aerobic exercise was in direct contradiction to ME/CFS experts. Paul Cheney explained “The most important thing about exercise is not to have them do aerobic exercise. I believe that even progressive aerobic exercise, especially in phase one and possibly in other phases, is counter-productive. If you have a defect in the mitochondrial function and you push the mitochondria by exercise, you kill the DNA” (Lecture given in Orlando, Florida, February 1999, at the International Congress of Bioenergetic Medicine).

Doctor Speedy weighs in with Is it NICE guidelines or NONSENSE guidelines? and the ME Association's Dr. Charles Shepherd pointed out during a meeting with Dr. Martin McShane of NHS England "that graded exercise therapy was causing harm to patients and that if a drug was causing harm, guidelines would be reviewed immediately."

Office locations and contact information

• London

National Institute for Health and Care Excellence

10 Spring Gardens

London

SW1A 2BU

Telephone: +44 (0)300 323 0140

Fax: +44 (0)300 323 0748

e-mail: nice@nice.org.uk

• Manchester

National Institute for Health and Care Excellence

Level 1A, City Tower

Piccadilly Plaza

Manchester

M1 4BT

Telephone: +44 (0)300 323 0140

Fax: +44 (0)300 323 0149

e-mail: nice@nice.org.uk

Online presence

• Linked In
• Newsletters and Alerts
• Twitter
• YouTube
• Website

See also

• NICE guidelines
• NHS
• PACE trial

See ME/CFS.

graded exercise therapy (GET) - A gradual increase in exercise or activity, according to a pre-defined plan. Focuses on overcoming the patient's alleged unhelpful illness beliefs that exertion can exacerbate symptoms, rather than on reversing physical deconditioning. Considered controversial, and possibly harmful, in the treatment or management of ME. One of the treatment arms of the controversial PACE trial.

See Graded exercise therapy.

cognitive behavioral therapy (CBT) - A type of psychotherapy geared toward modifying alleged unhealthy thinking, behaviors or illness beliefs. One of the treatment arms used in the controversial PACE trial.

See cognitive behavioral therapy.

NICE guidelines Clinical guidelines used in the UK.

See myalgic encephalomyelitis.

See chronic fatigue syndrome.

A drug trial involving only a small group of humans, often healthy volunteers, to assess drug safety and side effects. Typically 20-80 participants, often using a comparison group.

phase one A drug trial involving only a small group of humans, often healthy volunteers, to assess drug safety and side effects. Typically 20-80 participants, often using a comparison group.

mitochondria Important parts of the biological cell, with each mitochondrion encased within a mitochondrial membrane. Mitochondria are best known for their role in energy production, earning them the nickname "the powerhouse of the cell". Mitochondria also participate in the detection of threats and the response to these threats. One of the responses to threats orchestrated by mitochondria is apoptosis, a cell suicide program used by cells when the threat can not be eliminated.