Public Health Guidance Provided by NICE on Type 2 Diabetes - Essay Example

Running head: public health 19th July Introduction In the contemporary world, health has becomean important issue especially due to its role in the economic, social and political development of a country. Based on the health challenges in the developing countries as the result of high rate of poverty as well as poor feeding habits, various types of diseases have emerged resulting to increased cases of death (Linsley et al, 2011). Similarly, in the developed countries health departments and governments have come up with various strategies to assist their citizens to assess health services easily. By establishment of health care organizations such as the National Institute for Health and Care Excellence (NICE), the government has been able to provide effective guidelines to the communities. This paper seeks to identify five areas of public health guidance that are provided by NICE on type 2 diabetes. Additionally, the paper will also discuss the role of other organizations in producing the guidance as well as evaluation of the social, political, economical and environmental aspects facilitating the public health guidance. National Institute for Health and Care Excellence The National Institute for Health and Care Excellence aims at providing national guidance to improve health and social care. Having being formed in 1999 as the National Institute for Clinical Excellence, NICE is a non departmental public body that is under the department of health in UK (Sorenson et al, 2009). The renaming of National Institute for Clinical Excellence to National Institute for Health and Care Excellence came about in 2013 after the passing of the Health and Social Care Act 2012. NICE undertakes it duties by three notable ways. First, it embarks on providing evidence based guidance as well as advice for health to the social care practitioners and public health officials (Blustein, 2006). Secondly, NICE engages in developing quality standards and metrics that are used by those providing social care services and public health. Thirdly, the organization provides a range of information that across the spectrum of health care services. Evidence based guidelines and advice Since it was established in 1999 as National Institute for Clinical Excellence as indicated earlier, NICE has provided wide range of advice of effective as well as good value healthcare. During the month of April 2013, NICE was provided with a new duty that entailed providing guidance for the individuals working in a social care. Apart from encouraging healthy living to United Kingdom residents, NICE guidance emulates the necessary standards for quality health care (Boseley and Sparrow, 2008). Some of the parties that can use NICE evidence based guidelines include local authorities, voluntary groups, NHS and employers among others who are involved in provision of care and enhancing wellbeing (Martin and Baker, 2009). NICE guidance takes the following forms as discussed below. Evidence based recommendations Provision of evidence based recommendations on wide range of issues relating to health, managing and preventing particular health conditions, managing medicines in diversified settings, providing social care to both the children and adults as well as intervening in improving the health of the communities (Vella, 2011). NICE aims at providing integrated care where it is necessary. Appraisals of technology NICE is also responsible for assessing the implications of health technologies as far as cost is concerned. In addition to the biopharmaceutical products, NICE evaluates how new pharmaceuticals have impacted on the health provision costs (Garber, 2004). In this way, NICE ensures that all the patients have similar access to health services that are affordable and effective. Effective diagnostics guidance Through the use of modern technologies as well as diagnostics guidance, NICE is in a position to provide quality guidance to English NHS and the Welsh NHS. By establishing National Collaborating Centers, which involves experts from various colleges and health organizations, NICE has effectively met the need of the parties that require its guidance (Meetoo, 2007). Some of the notable organizations that NICE has partnered with includes National Collaborating Centre for Mental Health, National Collaborating Centre for Cancer, National Collaborating Centre for children health and women as well as National Clinical Guidelines Centre for Acute and Chronic Conditions. Social care guidance by NICE and other organizations According to Health and Social Care Act of 2012, NICE was provided with the duties to develop social care guidance as well as quality standards. These duties are to be achieved through the use of evidence based model. NICE responsibilities in terms of providing social care guidance are achieved through the assistance of organizations such as Social Care Institute for Excellence, Personal Social Services Research Unit, and Research in Practice for Adults. Quality standards and performance metrics A major responsibility of NICE is setting up of quality standards. This entails sets of statements that are prepared to measures the improvements that have been achieved. Other duties by NICE includes development of quality outcomes framework and clinical group outcomes indicator. In its responsibilities, NICE uses Pathways. These entail ways of accessing the information that relates to social care as well as clinical and public health issues from NICE. Example of the NICE Pathways includes quality standards and current NICE guidance among others. Through the use of topic based diagrams, NICE Pathways are important to the people who use NICE guidance since it allows the users to evaluate the depth as well as the breadth of the recommendations on any subject that covered by NICE (Thomas, 2009). One of the major aspects of NICE Pathways is that they present all the recommendation that NICE covers on a particular topic as well as the products that is supposed to support implementation of the NICE guidelines. Some of the notable products that are found in the NICE Pathways include public health, medicines practice guidelines, social care and clinical guidelines (Colvin and Lane, 2012). Others include technology appraisals, medical technology, quality standards and interventional procedures. Areas of public health guidance produced by NICE on type 2 diabetes In its efforts to offer the best support to the high risk individuals as far as type 2 diabetes is concerned, the National Institute for Health and Care Excellence has established various guidelines. The first area of NICE guidance on type 2 diabetes is the NICE public health guidance 35 of 2011. This guidance focuses at the individuals who work in local as well as national public health services. These include public health nutritionists, GPs, commissioners and directors as well as practice nurses among others (Pasquier, 2010). The guidance, which may also be of interest to the general public, is focused at preventing the type 2 diabetes among the adults who have high chance of being diabetic (Garber, 2004). This is achieved by addressing the risk factor that includes becoming overweight or being inactive. The second guidance that the NICE provides is NICE guidelines [PH25] of 2010. According to this guidance, which focuses at local authorities, government and individuals exposed to cardiovascular diseases, it is vital for individuals to take healthy diets in order to avoid type 2 diabetes as well as strokes (Boyle and Holben, 2011). Just like the NICE guidelines [PH35], NICE guidelines [PH25] can be adopted by the public. Major topic covered includes physical activity, reduction of consumption of salts and fatty foods, advising food outlets and assessing of local policies among others. Thirdly, NICE has established the NICE guidelines [PH38]. This guideline is focused at all parties who embark on identifying individuals who are the risk of getting type 2 diabetes, as preventing and delaying its spread. NICE guidelines [PH38] provide 20 recommendations that that can be used together with the NHS Health Check programme. Some of the key areas that are covered by this guideline include assessing risks, identification of risks, risk reassessment, physical activities and lifestyle changing programs among others (Tesfaye, 2009). The fourth guideline that NICE has initiated is NICE guidelines [PH27]. This guidance which is for managers, NHS and other professionals such as midwives, dietitians, obstetricians and health visitors who deals with pregnant women advocates for weight management. This includes assessing body weight, prevention of obesity and healthy eating in addition to being physically active (Carter, 2010). Fifthly, NICE has established NICE guidelines [PH42] which is focused at supporting the community to avoid occurrences of obesity that result to heart diseases and diabetes. The guidance is for managers, commissioners and policy makers. NICE guidelines (PH 38) In the recent past, type 2 diabetes has been on the rise. Approximately, 240 million people globally are estimated to have diabetes (World Health Organization, 2014). In their efforts to address and manage type 2 diabetes, health services centers embark on prevention of microvascular and cardiovascular diseases. One of the notable NICE guidelines on type 2 diabetes, referred to as NICE guidelines (PH 38), deals with risk identification and interventions for people at high risks. NICE guidelines (PH 38) aim at identifying individuals at high risk of type 2 diabetes followed by provision of cost effective and the best interventions for the individuals. It is worth to note that the guidance does not support the national screening initiative for the type 2 diabetes but NICE recommendations focuses at reminding the practitioners that age does not matter when it comes to developing type 2 diabetes (Leonid, 2009). Murphy et al, (2011) indicates that the recommendations which are adopted together with NHS health check initiatives, cover various areas that includes risk assessment, risk identification, matching risk to interventions, reassessing the risks, physical activity, providing advice on diets, weight management advice, training and professional development and metformin among others. NICE guidelines (PH 38) are directed to individuals with direct role and duty to prevent or manage type 2 diabetes. These individuals include nurses, GPs, health professionals in private sectors, local authorities, managers and commissioners, voluntary sectors and general public among other parties (Paul, 2010). Other notable people who are focused by the guidance include occupational health specialists, pharmacists, individuals involved in the NHS Health Check initiatives and optical practitioners. Reasons for producing the NICE guidelines (PH 38) The National Institute for Health and Clinical Excellence was directed by Department of Health in UK to establish a public health guidance that deals with the prevention of type 2 diabetes among the groups that are highly exposed to the disease. The first part of the guidance dealt with prevention as well as delaying the developing of pre-diabetes stage to type 2 diabetes among individuals who are highly likely to get the disease (Wolfsdorf, 2012). The second part was concerned with the preventing the adults between the ages of 18 to 74 years within the society who are highly exposed to developing type 2 diabetes from getting into the state of pre-diabetes. In its effort to address the challenges faced during the type 3 diabetes diagnoses among the non-pregnant adults, the World Health Organization recommended the use of glycated haemoglobin instead of normal glucose measures (Ripoll, 2011). By adopting the second part of the guidance, NICE aims at identifying people who are 18 years and more so who are at the risk of getting the type 2 diabetes and then providing them with health strategies for example appropriate lifestyle-change initiatives to delay the condition or preventing it completely (Swinnen, 2011). When combined, the two parts of the guidance provides an extensive approach that focuses at prevention as well as interventions that aims at assisting the members of the community who are at high risk of contracting the type 2 diabetes (Colucci, 2011). One of the notable aspects of this guidance is that it can be used together with NHS Health Check initiative as noted earlier as well as national vascular risk assessment management programme for members of the society who are aged 40 to 74 years. According to NHS Health Check Programme (2009), the three aspects forms an approach whose main objective is prevention of the four diseases that includes stroke, diabetes, kidney illness and cardiovascular disease. As it is being adopted in the entire area of England, the programme aims at making sure that all the individuals who are aged between 40 to 74 years who have not been noticed to have any of the 4 diseases are provided with risk assessment and be given full support to prevent or manage such risks (Raina and Kenealy, 2008). Development of NICE guidelines (PH 38) NICE guidelines (PH 38) were developed by Program Development Group by following the NICE public health programme process (Chris, 2011). Some of the notable members of Programme Development Group include Pam Brown, Barry Cassidy, Christine Cottrell, Melanie Davies and Richard Holt who is a Professor in Diabetes at the University of Southampton among other experienced members. Evidence on which NICE guidelines (PH 38) was based on Program Development Group based their recommendations on economic modeling, reports by commissioners, testimony from experts, stakeholder’s efforts and fieldwork. The three considerations that the PDG came up with include terminology, type 2 diabetes prevention and economic modeling. Some of the key issues that are covered by the guidance include impaired glucose regulation, glycated haemoglobin (HbA1c), risk-assessment tools, type 2 diabetes prevention trials and examination of individuals aged between 40 to 74 years (Saad and Gooren, 2009). During the process, the PDG used the NHS Health Check programme as a comparing tool. Social factors facilitating the NICE guidelines (PH 38) This public health guidance is not only for professionals in the field of health but also it caters for the needs of families with individuals who are at high risk of type 2 diabetes. Thus it creates effective way through which information is delivered to the public. NICE guidelines (PH 38) provides exhaustive life-style change programme that surrounds the social lives for UK individuals (Lawrence, 1965). Thus, the program trains the public on how to leave an appropriate social lives and good eating habits. Political factors facilitating the NICE guidelines (PH 38) As an initiative that was established by the Department oh Health in UK, NICE guidelines (PH 38) has experienced support from all stakeholders due to its effectiveness in meeting the health needs of the local communities. Economical factors facilitating the NICE guidelines (PH 38) Through the application of economic models by the PDG during the establishment of the guideline, it has taken in to account the changing economic position of individuals. The guideline was established by use of data from UK residents that was compared with data from South Asian decent (Webster, 2011). In this way, the guideline was made to be more reliable. Environmental factors facilitating the NICE guidelines (PH 38) One of the key issues that make the guideline to be effective is based on the wide range of information that came from sources located from different environmental conditions. For example, in the commissioned report, the research was undertaken from vulnerable group in the prisons, refugee camps, poverty stricken areas and learning institutions among other places (John, 2007). Costs As compared to other guidance, NICE guidance (PH 38) is cost effective. According to the PDG, the aim was to come up with an effective guideline that was also cost effective in order to be affordable by the majority of vulnerable groups. Through the support of the Department of Health, the guidance has made it to be easily accessible by many people thus making it to achieve the preset objectives. Implications of the NICE guidance (PH 38) for public health One of the major implications of this guidance is that it will make the public be aware of the poor feeding habits that may negatively affect their body sugar level. Being a guidance that was initiated by professional who were in the PDG, the guidance will significantly reduce the cases of type 2 diabetes not only in the UK but also other countries who may borrow its recommendations. Additionally, the guidance will bring about new ideas on how to deal with type 2 diabetes globally. Conclusion Based on the above discussion, it is clear that UK has put strong policies to address the health problems affecting its citizens. Most importantly, the Department of Health through the NICE guidance for public health has implemented strong strategies to deal with type 2 diabetes. Major guidelines that NICE has adopted to deal with type 2 diabetes include NICE guidance (PH 38), NICE guidance (PH 35), NICE guidance (PH 25), NICE guidance (PH 27) and NICE guidance (PH 42) (Ganz, 2005). NICE guidance (PH 38), which was established by PDG in 2012, is cost effective and covers wide areas due to the extensive research touching on economic, political, social and environment issues. References Blustein, D. 2006. The psychology of working: a new perspective for career development, counseling, and public policy. Mahwah, N.J.: Lawrence Erlbaum Publishers. Boseley, S and Sparrow, A. 2008. Johnson lifts NHS ban on top-up treatment. Guardian Newspaper. Available from http://www.theguardian.com/politics/2008/nov/04/nhs-health-cancer-topup-treatment Boyle, M and Holben, D. 2011. Community nutrition in action: An entrepreneurial approach. Belmont: Wadsworth. Carter, P. 2010. Fruit and vegetable intake and incidence of type 2 diabetes mellitus. New York: Springer. 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