National Institute for
Health and Care Excellence
Annual Report and Accounts
2025 to 2026
Chairman's foreword
Sharmila Nebhrajani OBE
This has been a year of considerable significance for NICE. Against a backdrop of major policy reform, senior leadership transition and rapid technological change, the organisation has continued to advance its core purpose: to help health and care practitioners and commissioners to get the best care to people fast, while ensuring value for the taxpayer.
During this year, I was delighted to announce Professor Jonathan Benger as NICE’s new chief executive, succeeding Dr Sam Roberts. Jonathan will be well known to many of our partners, having joined NICE in January 2023 as chief medical officer and since holding roles of interim director of the Centre for Guidelines and deputy chief executive. He is widely respected, and his extensive frontline clinical and national policy experience make him well placed to lead our organisation through the next phase of its development. I am confident that under his outstanding leadership, NICE will continue to deliver on its commitments under the 10 Year Health Plan, the Life Sciences Sector Plan - and, most critically of all, the needs of clinicians, commissioners and patients.
Ending the postcode lottery for healthtech
NICE was originally established in 1999, in part, to address a perceived postcode lottery for medicines access in health and care. Many of the same challenges have long faced healthtech: inconsistent access across the country and unclear signals about which technologies offer the best value to the health system. The government has recognised the critical importance of healthtech to patient outcomes. It is therefore especially pleasing that, as part of the 10 Year Health Plan, NICE’s mandate has been broadened to encompass high-impact healthtech – after many years of discussion and debate.
Through close collaboration with the Department of Health and Social Care, NHS England, the Medicines and Healthcare products Regulatory Agency and the Office for Life Sciences, NICE has developed the National Healthtech Access Programme - a structured framework designed to bring clarity, consistency and rigour to the evaluation and adoption of selected high-impact healthtech. Crucially, the programme has a funding mandate that assures financial support for the commissioning of the technology, akin to that for medicines, removing one of the biggest barriers to adoption. In February 2026, we announced the first 2 topics to be assessed through the programme:
- capsule sponge tests for the detection of Barrett’s oesophagus and oesophageal cancer
- AI-assisted tools for identifying prostate and breast cancer.
Both technologies hold significant potential to transform early diagnosis for thousands of patients each year, while driving workforce efficiency and releasing capacity across the NHS.
The pace of change in the healthtech sector is considerable, and these 2 product areas represent just the beginning. Healthtech offers remarkable possibilities for earlier diagnosis and preventative care. NICE wholeheartedly embraces the task of distinguishing the most clinically and cost-effective technologies, providing clear guidance to commissioners and practitioners that will help to simplify decision-making at the point of care.
The Life Sciences Sector Plan underscores the importance of accelerating innovation for the UK economy and strengthening its position as a life sciences superpower. Our work on high-impact healthtech directly supports this ambition, situating the NHS as a powerful and credible customer for one of the UK's fastest-growing industries. From digital therapies to advanced diagnostic tools, NICE will work in partnership with industry and our system partners to bring life-changing innovations to patients across the country.
Changes to NICE’s evaluation thresholds
In December 2025, the government announced that it would increase the thresholds NICE uses in its evaluations of new medicines for use in the NHS.
In a health service funded by general taxation, it is right that government determines the level of health spend in the UK. The thresholds are the manifestation of that choice.
NICE's global reputation for robust, rigorous, transparent guidance will be unaltered as our independent committees apply the new value for money thresholds in their deliberations from April 2026. We have been working to introduce these changes fairly and swiftly to provide clarity for patients and industry.
We currently recommend 91% of the medicines we evaluate, around 70 a year. Our analysis suggests that increasing the standard threshold to £25,000 to £35,000 will allow us to recommend an additional 3 to 5 new medicines or indications per year. Our assessments use quality-adjusted life years (QALYs) to estimate the health benefits of new medicines. Alongside adjustments to the cost-effectiveness thresholds, we are introducing a new value set for assessing health-related quality of life.
The new EQ-5D-5L value set is based on a questionnaire that captures how someone’s health affects their daily life - an update from the previous dataset, which dated back to the 1990s and looked at 3 response options rather than 5. Adopting the new value set means NICE will be able to make more accurate assessments of how treatments improve health-related quality of life. This change may additionally impact the cost-effectiveness of medicines.
Our commitment to patients and the public
NICE is committed to playing a central role in ensuring the UK remains at the forefront of life sciences innovation, while delivering a sustainable, equitable and effective health service for all. That commitment is made possible by the dedication and expertise of our staff and our committee colleagues. On behalf of the whole board, I wish to extend sincere thanks to our senior leadership team, to our staff, and most of all to those who serve on our committees - clinicians, patient representatives, academics and industry colleagues who each bring their wisdom, compassion and rigorous intellect to our decisions, often giving of their time free of charge. We could not do it without you.
Thank you.
Chief executive's foreword
Professor Jonathan Benger
I am delighted to present NICE’s annual report and accounts, which summarise our key achievements and financial activity from April 2025 to March 2026.
This is my first report since taking up the role of chief executive in December 2025. NICE plays a vital role in helping practitioners and commissioners get the best care to people, fast, while ensuring value for the taxpayer. It is an institution I have in-depth experience of, through my previous roles in academia, medicine and as a clinical leader, including as NICE’s chief medical officer for the past 3 years. In many ways, this appointment feels like a culmination of my career, and it is a role that I am deeply honoured to take on.
Building on strong foundations
I would like to pay tribute to my predecessor, Dr Sam Roberts, for the work she did leading the organisation. Sam initiated the transformation plan that we are continuing to deliver, ensuring NICE is equipped to meet the evolving needs of patients, clinicians and commissioners. Since the plan was launched in 2022, we have focused on delivering outcomes across the system, with particular emphasis on improving our timeliness. As a result, we now publish guidance 30% faster for medicines and 9% faster for healthtech – a testament to the shared commitment of our partners and stakeholders and the dedication of our staff.
A landmark expansion of NICE’s role
NICE was one of several key partners who contributed to the development of the 10 Year Health Plan, which was published by the government in July 2025.
The plan marks a pivotal moment for the health and care sector. After years of unprecedented pressure on the health service, the plan charts a clear path from reactive care to prevention, from hospital to community, and from analogue to digital.
The plan expands NICE’s remit in 3 key areas, enabling us to:
- provide faster, fairer rollout of high-impact healthtech
- keep guidance up to date to drive smarter spending
- make parallel decisions for faster medicines access.
Since the plan was announced, we have been working to translate these commitments into operational reality.
Faster, fairer rollout of high-impact healthtech
The launch of the National Healthtech Access Programme in February 2026 represents a significant step, and I look forward to reporting further progress as the programme develops.
Keeping guidance current to drive smarter spending
Our whole lifecycle approach helps the NHS to stay up to date with best practice. We maintain guidance that reflects changes in evidence, costs, and clinical practice. Through this approach, we will continually review what works best, establish where care can be improved, and highlight where treatments should evolve over time. It will also enable us to expand access to cost-effective innovations, including biosimilars.
Working in partnership to accelerate access
We are working closely with the MHRA to streamline regulation and market access. This collaborative work will enable us to bring medicines to patients 3 to 6 months sooner. Rather than NICE determining the clinical and cost effectiveness of a medicine after the MHRA determines safety, we will, where possible, publish both decisions at the same time by working more closely with the MHRA, while supporting and fostering a strong life sciences industry.
The growing importance of our work
As we face growing healthcare demand and the rapid development of new medical technologies, our work has never been more important. I have seen firsthand, both as a doctor in emergency medicine and in my work across the wider NHS, how the right guidance at the right time can transform patient care.
We have significantly expanded our portfolio of guidance on health technologies, including diagnostics, medical devices and digital health tools. Our portfolio of digital technology guidance is now more than 30 times bigger than it was in 2022.
However, unprecedented demand on the health service requires us to enhance our effectiveness and efficiency. We must be willing to review and redesign our processes and implement supporting digital technologies to achieve more with our current resource. A key part of this will be to combine and unify our guidance output. If our guidance is to remain relevant, useful and usable to our health and care practitioners it must be presented in a way that is readily accessible to them.
A unified approach to prioritisation
With more than 27,000 recommendations in our guidance portfolio currently, we simply cannot keep every topic up to date while meeting the continuing demand for new guidance. Therefore, we must prioritise to ensure we are focusing on the areas that matter most and find innovative ways of producing and maintaining the full range of guidance that our users expect. One significant development during my previous role as NICE’s chief medical officer, was to develop a unified approach to prioritisation across the organisation.
We unified our processes by developing a new prioritisation framework and establishing a single NICE-wide prioritisation board. This means we can produce guidance in a way that is more coordinated, transparent and efficient. It also makes it easier for stakeholders to understand NICE’s priorities, and plan ahead.
The prioritisation board, made up of senior NICE staff, ensures the topics we select reflect national priorities for health and care, for example the new modern service frameworks that are being developed by the National Quality Board.
As part of this new approach to prioritisation, we publish a forward view annually, describing the areas we will prioritise in the coming year. In April 2026, we launched a comprehensive update to the forward view, outlining how our guidance aligns to key sector priorities, such as the 10 Year Health Plan and the Life Sciences Sector Plan.
Looking ahead with gratitude and ambition
To conclude, I would like to express my sincere thanks to our partners, collaborators, commissioners and practitioners who have welcomed me into my new role and supported NICE in achieving our strategic priorities. I had the pleasure of connecting with many of you at our annual conference and it was invaluable to hear your perspectives on the work of NICE and the wider health and social care sector. I look forward to continuing these conversations during my tenure as chief executive.
I am grateful, as always, to the board and chairman for their support, and for the strong leadership and strategic insight they bring to ensure the organisation continues to deliver on its mission. I would also like to express my thanks to our committee members and the staff of NICE, who have shown such commitment and diligence in their work. I have every confidence that we will remain true to our values and core purpose as we continue our shared journey of development and transformation.
My priority is to build on NICE's reputation for independence, transparency and rigour. We will continue to support the delivery of excellence in healthcare. I look forward to the progress we will make together in delivering our mission in the years ahead.
Key facts and figures
Our transformation plan
Relevant
200 topics reviewed by our prioritisation board so far, making sure we focus on the topics that matter most.
Timeliness
Since April 2024, we’ve improved the speed of our appraisals by:
30% for medicines
9% for healthtech
Impact
73.6% of NICE-recommended medicines were prescribed more between January to December 2025.
Usability
More than four-fifths of our users report that NICE guidance is usable.
Guidance highlights
New sepsis guidelines could transform care for up to 245,000 patients a year.
Up to 500,000 to benefit from new non-hormonal treatment for hot flushes caused by menopause, when HRT is unsuitable.
Bringing hope to over 80,000 people with vitiligo through the first recommended licensed treatment for the condition.
178 pieces of new and updated guidance and standards published
More than 27,000 guidance recommendations since 1999.
98 new medicines evaluations
*Appraisal terminated due to lack of evidence submitted, or evidence not meeting specifications
The 10 Year Health Plan for England
Empowering NICE to help deliver better care to people, faster
In July 2025, NICE welcomed the publication of the government’s 10 Year Health Plan for England.
The plan endorsed NICE’s role in delivering faster, fairer access to innovations. Strengthening our role in the system and guided by our core purpose, it will enable us to become more relevant, timely, usable and impactful, through the delivery of 3 key priorities:
- faster, fairer roll out of high-impact healthtech
- updating guidance to drive smarter spending
- parallel decisions for faster access.
We are already delivering on our commitments. Over the past few years, we have been laying the foundations for these approaches through our transformation plan. It means we are already using our expanded remit to carry out smarter innovations across the system.
Faster, fairer roll out of high-impact healthtech
People across England and Wales are set to receive faster, fairer access to innovative healthtech with our new national programme.
Launched in February 2026, the new National Healthtech Access Programme is a collaborative approach between NICE, the Department of Health and Social Care, NHS England, MHRA and the Office for Life Sciences. The approach will include expanding NICE’s technology appraisals in health technologies. This means that, like medicines, high-impact technologies will be reimbursed and made available across the entire health service.
NICE has announced that the first 2 topics to go through the new programme are capsule sponge tests for detecting Barrett's oesophagus and oesophageal cancer and AI tools for identifying prostate and breast cancer – technologies that could transform early diagnosis for thousands of patients each year, and drive workforce efficiency in the NHS through releasing capacity.
The new programme aims to create a far better experience for patients and NHS professionals, unlocking the extraordinary potential of healthtech advances and the UK’s healthtech sector.
Updating guidance to drive smarter spending: a whole lifecycle approach to guidance production
NICE is evolving towards taking a whole lifecycle approach to guidance production. This means that NICE will maintain up-to-date guidance reflecting changes in evidence, costs, and clinical practice.
This means NICE will not just assess a new medicine or treatment once and move on. In priority clinical areas, NICE will review its guidance as the evidence grows – so that NHS care remains focused on what benefits patients most.
In addition, this new approach will enable NICE to expand access to cost-effective innovations, including off-patent medicines. This will provide clearer decision pathways for clinicians, and help create financial headroom for tomorrow’s clinical breakthroughs.
It is important that our users can find everything that NICE has recommended on a condition in one place. But the seamless incorporation of recommendations for medicines or healthtech into guidelines is not always possible. This is due to the differences in approach and evidence used in each of NICE’s guidance producing programmes. Under the whole lifecycle approach, we are working on ways of bringing our guidance together.
Parallel decisions for faster access
NICE is helping to deliver the government’s ambition to streamline regulation and market access. Working in collaboration with the MHRA, we have introduced a new aligned pathway that will enable us to bring medicines to patients 3 to 6 months faster.
We have ensured that our processes remain rigorous, independent and transparent. But, instead of NICE determining the clinical and cost effectiveness of treatments after MHRA rule on their safety, where possible both decisions will be published at the same time. The pathway aligns licensing and value decisions to reduce unnecessary delays and get treatments to patients sooner.
To help companies stick to the timelines of the new aligned pathway, NICE and MHRA are also launching a new improved Integrated Scientific Advice service. Announced at our annual conference in March, the service offers a more streamlined experience to help companies follow the aligned pathway timelines and reduce unforeseen delays.
Relevance
Focusing on what matters most
Prioritising our guidance topics
Since 2024, NICE has adopted a centralised approach to prioritising its guidance topics. This ensures the guidance we produce is relevant, timely, accessible and impactful.
We do this through a prioritisation board, whose role is to:
- review and discuss topics, which will enable effective and consistent decision-making for guidance prioritisation
- maintain a forward view of topics and a rolling plan that responds to system need and demand
- publish decisions to provide visibility and transparency to enable effective sharing of information with our stakeholders.
Since its creation in 2024, NICE’s prioritisation board has made over 200 decisions, ensuring we focus our efforts where they matter most.
Forward view - highlighting NICE's priority topics
As part of our approach to prioritisation, each year we produce a forward view.
The forward view highlights the areas NICE will prioritise in the coming year. Topics are refreshed annually and in response to major developments in the life sciences and health and care sectors.
On 1 April 2026, NICE fully updated its forward view to ensure our guidance is aligned with national strategic priorities including:
- the 10 Year Health Plan
- modern service frameworks
- biosimilars and generics.
Embedding changes to NICE’s Highly Specialised Technologies (HST) routing criteria
Following board approval in March 2025, NICE has implemented changes to the routing criteria for Highly Specialised Technologies (HST) to ensure more consistent, predictable and transparent decision-making.
Our HST programme supports research and innovation in areas with small patient populations – specifically conditions that affect fewer than 1 in 50,000 people.
We have introduced a revised routing assessment checklist. Since then, 10 topics have been considered by the prioritisation board using the refined criteria – 1 routed to HST and 9 to standard technology appraisal.
Case study
How NICE's whole lifecycle approach is helping to transform diabetes care
Millions of people are set to benefit from earlier access to newer type 2 diabetes treatments – the biggest shakeup in care for a decade – as part of our commitment to re-evaluate priority clinical pathways set out in the 10 Year Health Plan.
Around 4.6 million people are diagnosed with diabetes in the UK according to Diabetes UK, with about 90% of those having type 2. Additionally, it is estimated that almost 1.3 million people in the UK are likely to have undiagnosed type 2 diabetes.
Our updated guidance moves away from automatically starting everyone on the same medicine. Instead, it supports personalised treatment plans aimed at preventing heart failure, heart attacks and other serious conditions. This shows updating guidance can drive smarter NHS spending while ensuring more people receive the right medicines to reduce their future risk of ill health.
Case study
Promising AI innovations for earlier bowel cancer detection
In November 2025, NICE conditionally recommended 6 AI technologies for use in the NHS, to help doctors detect bowel cancer earlier during colonoscopy examinations.
The tools monitor the live camera feed used during clinical investigations and alert doctors to areas where polyps, small growths that can develop into cancer if left untreated, may be present. The doctor remains in complete control of all clinical decisions, and the technology typically adds only a minute or 2 to the appointment.
Bowel cancer is the UK's fourth most common cancer, affecting over 42,000 people each year. Diagnostic tools such as these have the potential to save lives through early detection.
We're allowing these technologies to be used now because they show real promise, while we gather the detailed evidence we need to understand their long-term impact.
Using biosimilars and generics to strengthen NHS sustainability
The NHS in England spends nearly £21 billion on medicines each year, making it essential that this investment delivers value for both patients and the NHS. One way to do this is by supporting the use of biosimilars and generics where clinically appropriate – a key part of the government's strategy for providing value for the health and care system.
In 2025, NICE played an instrumental role in establishing a new collaborative Biosimilar Taskforce, bringing together the MHRA, NICE, NHSE and DHSC to coordinate activity across the system.
Under NICE’s commitments in the 10 Year Health Plan, we are developing a whole lifecycle approach to guidance development. Biosimilars and generics form part of this approach, supporting the NHS to stay up to date with best practice.
By aligning NICE guidance updates, NHSE commissioning activity and MHRA regulatory decisions, the taskforce is accelerating access to cost-effective medicines, improving population health and delivering better value for taxpayers.
Supporting action on health inequalities: a new digital resource for practitioners
In March 2026, we updated our health inequalities web pages. The new pages outline how you can use our recommendations, tools and resources to improve population health as a whole, while offering particular benefit to the most disadvantaged. This update focuses on measures to address health inequalities in cardiovascular disease, and maternity and neonatal health, with future topics planned to include respiratory disease, cancer and mental health.
Leading the way on safe and effective AI in healthcare
The use of AI in healthcare is advancing rapidly. At NICE, we want to be at the forefront of this revolution. Our ambition is to lead the way in identifying and harnessing the potentially transformative benefits of these fast-paced technologies.
Last year, we developed our first guidance to companies on the use of AI in evidence generation and cost-effectiveness modelling. We are committed to supporting productivity across the UK’s medicines and healthtech sectors through further work in this area.
We began testing and implementing the use of AI in the methods and processes we use to develop guidelines, with the aim of providing more responsive guidance to the health and care sectors.
Timeliness
Helping to get the best care to people, fast
Accelerating our medicines evaluations by 30%
Over the last 2 years, our improving timeliness programme has driven meaningful change in how we plan, manage and deliver guidance. This ambitious programme spans the whole organisation, aiming to ensure that people receive promising treatments at the earliest possible opportunity.
We have made real progress this year, accelerating our medicines evaluations by 30%. We are on course to achieve our ambition of making England the third fastest country in Europe for access to medicines by 2030.
Speeding up our internal processes
In 2025, NICE embedded new tools, data and processes to transform topic, committee and stakeholder management.
Through the programme, we have delivered:
- A single, centralised management system, replacing fragmented team-level stakeholder data and migrating nearly 50,000 records.
- A new committee hub that centralises document sharing, collaboration and resources. All committees now use the system, reducing administration time by 25%.
Shared systems, improved data visibility and aligned processes will support more consistent planning, reduce manual effort and strengthen collaboration. This will help ensure more predictable and timely delivery of guidance.
Bringing medicines to patients sooner through a new aligned pathway between NICE and the MHRA
Working with the MHRA, we have developed a new aligned pathway. The new MHRA-NICE aligned pathway launched on 1 April 2026 and marks a significant step forward in reducing the time people wait for access to new medicines.
Following commitments in the government’s 10 Year Health Plan and Life Sciences Sector Plan, the aligned pathway will help to bring NICE's decision-making process forward to run alongside the MHRA's. This means that decisions on licensing and value will be made in parallel for the first time.
Alongside the pathway, NICE and the MHRA are also launching an improved Integrated Scientific Advice service, offering a single-entry point, one advice meeting, one report and one payment. This service has been designed to help companies follow the aligned pathway timelines by clarifying regulations and the evidence needed early in the development process. This will support companies to improve their clinical development plans and reduce unforeseen delays.
By working more closely with our partners at the MHRA, we can get medicines into the NHS faster, helping to improve people's health and ease pressure on NHS services.
Our continued collaboration makes the UK an even more attractive launch market for the global life sciences industry, so will boost R&D investment and economic growth in this country.
NICE Conference 2026
The launch of the aligned pathway was announced at the NICE Conference in Manchester on Tuesday 17 March by NICE and MHRA chief executives, Jonathan Benger and Lawrence Tallon.
The conference brought together over 500 senior managers, policy makers, commissioners, people with lived experience, frontline health and care staff and industry leaders for a day of insight and collaboration.
Presentations, panels and debates explored topics ranging from focusing on prevention to driving NHS reform through innovation.
Case study
Faster access to life-extending prostate cancer treatment
Following a NICE recommendation in October 2025, up to 6,000 people in England with metastatic hormone-sensitive prostate cancer can now access darolutamide (Nubeqa). This new treatment combination offers healthcare professionals and patients greater flexibility in managing this advanced condition.
By applying a cost-comparison appraisal approach and assessing darolutamide against an already recommended equivalent treatment, NICE published its final guidance 5 weeks faster than under the standard process. As a result, people were able to access a clinically effective, life-extending treatment significantly sooner.
We are determined to ensure that effective treatments such as darolutamide are made available fast to the people who need them.
Usability
Making sure our guidance is useful and usable
Redesigned sepsis guideline makes vital information easier to find
Sepsis affects at least 245,000 people in the UK each year and can be fatal if not treated promptly. In November 2025, NICE restructured its sepsis guidance to help health and care professionals find the information that is relevant to the person they are treating, more quickly. The update followed feedback from practitioners about how the guidance is used in practice.
To support swift implementation of the updated guidance, NICE worked closely with The UK Sepsis Trust to ensure its free clinical tools reflect our latest recommendations. The tools are designed to make applying the guidance as straightforward as possible in practice and are downloaded nearly 3,000 times a month from the UK Sepsis Trust’s website.
The guidance is now organised into 3 guidelines, covering:
- adults
- children and young people
- those who are pregnant or were recently pregnant.
Hywel Dda University Health Board commented that separating the guidelines makes them easier to benchmark against, as coordination and stakeholder management improved when handled by different teams.
Hearing from our users: a strong vote of confidence
We are working to meet the future challenges and opportunities of an evolving health and care system. To make sure that we are progressing as intended with supporting the system in delivering better health outcomes for our communities, we conduct an annual reputation research project. The survey provides us with a robust understanding of what our stakeholders think, and what they need from us.
In the latest survey, conducted in September and October 2025, 82% of nearly 800 respondents agreed that NICE produces guidance which is usable. This is an increase of 4 percentage points since our previous survey in 2024.
Building a better digital experience for health and care professionals
NICE’s content transformation work is focused on improving the usability of guidance for the health and care system, making it easier to navigate and presented in a way that supports better decision-making. In July 2025, the NICE board approved the business case for a new user-focused knowledge platform to create, store, manage and publish guidance content. The platform will break our guidance down into components, which will allow us to rebuild products based on our users' needs. Over the past year, we have been preparing the ground to begin delivery of this transformational work.
Building on this foundation, NICE successfully migrated its website to a modern system, bringing together expertise across content, design and technology to deliver a more accessible, intuitive digital service. The transformation has streamlined publishing, improved navigation and created a flexible foundation for future digital work, with early analytics and feedback confirming a better user experience.
Consistent, actionable recommendations for our users
Ensuring that our users can access and understand our guidance recommendations is a vital part of our work. We are committed to improving the clarity and consistency of how we write our recommendations across all our guidelines. Building on last year’s work to simplify our medicines and healthtech recommendations, all recommendations will include, as a minimum:
- an action
- a population
- an indication.
We are also exploring ways of presenting the rationale behind our committees' recommendations more transparently, and how to provide contextual information to support users in putting guidance into practice.
Case study
Making NICE guidance work for everyone
Somerset NHS Foundation Trust demonstrates how NICE guidance can be applied effectively in a specialist clinical setting. In 2025, the trust adapted its weight management pathway to incorporate injectable anti-obesity medications. The service translated national guidance into practical, person-centred care for patients with complex needs, including neurodiversity, learning disabilities and mental health conditions.
The guidance provided a clear framework that clinical teams could build upon, allowing them to design tailored support structures such as enhanced monitoring and proactive staff training.
The trust's experience illustrates that NICE guidance is sufficiently flexible to be implemented meaningfully across diverse patient populations and in real-world service contexts.
Impact
Working with our partners to increase the uptake of our guidance
Our recommendations help practitioners and commissioners get the best care to people, fast. This year, we have continued to work with partners across the health and care system to increase the impact of our guidance.
- Working in collaboration with CVDPREVENT, a national primary care audit, we ensured alignment between NICE guidance and the care measured by the audit and supported the dissemination of key insights.
- Latest figures show that 76.6% of NICE-approved medicines were prescribed more frequently in the 12 months to June 2025 compared with the previous year. Data from the NHS Business Services Authority Innovation Scorecard says 16 medicine groupings saw increased uptake across local NHS services in England.
- We held engagement events with more than 35 integrated care boards (ICBs) in the 7 NHS England regions to discuss our priorities and understand how we can support their focus on strategic commissioning. We also launched an ICB reference panel to guide our work and gain system feedback.
Case study
1 year of the joint BTS, SIGN and NICE guideline on asthma
In Dudley, a pharmacist-led one-stop respiratory clinic is demonstrating the real-world impact of the asthma guideline, 1 year after its publication. Led by specialist respiratory pharmacist Nazir Hussain, the clinic uses prescribing data to identify potentially missed diagnoses, conducts diagnostic testing and integrates with local hospital services.
The results have been significant: referral to treatment times fell from up to 52 weeks to under 6 weeks, 69% of patients had inhaler technique errors corrected, confidence in managing exacerbations increased from 66% to 99%, and 100% rated their consultations as either 'excellent' or 'very good'.
The Dudley model illustrates the value of translating national guidance into local practice and supports the NHS's broader shift towards prevention and community-based care.
Delivering tools that aid implementation
We work collaboratively with ICBs to support implementation by offering practical tools such as costing templates, implementation support resources, and evidence reviews.
Since we published our asthma guideline, in partnership with the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN), we have developed a suite of resources to help healthcare professionals and commissioners implement the guidance. These resources, available on our website, include:
- resource impact summary
- commissioning summary
- decision aids
- 6 case studies
- a podcast.
Case study
First treatment for vitiligo recommended by NICE, bringing hope to over 80,000 people
In February 2026, we recommended ruxolitinib cream (Opzelura) as the first licensed vitiligo treatment available on the NHS in England.
Vitiligo occurs when the immune system attacks the cells responsible for skin pigmentation, causing pale pink or white patches that can significantly affect emotional and social wellbeing. Ruxolitinib works by calming the immune response, allowing natural skin colour to return.
Clinical trials found that the proportion of people seeing a substantial facial repigmentation (at least 75%) was 4 times higher when using ruxolitinib compared with placebo, and 6 times more likely to report their vitiligo becoming less noticeable or no longer visible.
It is clear NICE listened to the evidence presented by patients on the impact of vitiligo on their lives.
Case study
Hybrid closed loop systems transforming type 1 diabetes care for children and young people
Since NICE-recommended hybrid closed loop systems for type 1 diabetes there has been a jump in uptake of the device from just over one-third to nearly three-quarters in 2 years.
Provisional data from the National Paediatric Diabetes Audit in December 2025 shows that 73% were using hybrid closed loop systems, up from 36% in 2023.
Hybrid closed loop systems, often referred to as 'artificial pancreas' devices, help to reduce the daily burden of type 1 diabetes for families managing this complex condition. The system combines an insulin pump, continuous glucose monitor, and an algorithm that work together to automate insulin delivery.
The benefits extend beyond clinical measures, including improved sleep, reduced anxiety and greater independence for children. Claire Wragg, whose son uses the system, described it as "life changing."
Our international work
NICE helps set the global standard for health technology assessment
The Health Economics Methods Advisory (HEMA) collaboration was founded by NICE, the US-based Institute for Clinical and Economic Review, and Canada's Drug Agency. It was established as an independent, authoritative voice to develop and share best practice in health technology assessment.
In March 2026, HEMA published its first report, setting out a framework and 3 guiding principles to help organisations decide which benefits should be included in economic evaluations. These include productivity impacts, people’s attitudes to risk, and the equity implications of new interventions. NICE will consider the recommendations and apply as appropriate to future methods updates.
Advancing global health through evidence-based decisions and strong relationships
NICE International recognises that strong partnerships are essential to strengthening global health systems and ensuring equitable access to high quality healthcare services. In 2025 to 2026, NICE International engaged with more than 20 countries, from Peru to the Philippines.
To help address the market access barriers faced by UK companies entering overseas markets, 13 countries received tailored support from NICE through the Ricardo Fund, a Department for Business and Trade programme. NICE International provided advisory services and knowledge-exchange activities, to help local teams strengthen health technology evaluation in countries including Brazil, Egypt and Ukraine.
NICE International began a new project with Ghana as part of the NHS Consortium for Global Health. The team supported the National Health Insurance Agency with health economic analyses to underpin the implementation of free universal primary healthcare. This collaboration informed wider discussions on health technology assessment in Ghana and created opportunities to engage with a wider network of countries in Sub–Saharan Africa.
In the same period, NICE International began a consultancy project with the Ministry of Health in Oman focused on guideline development and quality improvement. An in-country engagement in Muscat was followed by further discussions at the ISPOR-UAE conference, helping to build relationships across the Middle East.
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