NICE update: guidance to support virus response

NICE is supporting both the NHS and social care to respond quickly to the challenges of the coronavirus pandemic, writes Gary Shield. It has brought together information at www.nice.org.uk/covid-19.

Part of the response has been to develop rapid guidelines on the care of people with suspected and confirmed Covid-19 and in patients without Covid-19. The guidelines aim to maximise patient safety while protecting staff from infection and making the best use of resources.

A guideline on critical care  covers: admission to hospital; admission to critical care; starting, reviewing and stopping critical care; clinical decision making; and service organisation. It stresses that all patients on admission to hospital should continue to be assessed for frailty using the clinical frailty scale.

For patients with confirmed Covid-19, the guideline says decisions about admission to critical care should be made on the basis of medical benefit, taking into account the likelihood that the person will recover to an outcome that is acceptable to them.

Two further guidelines cover kidney dialysis and systemic anticancer treatments.

The guidelines have been developed in collaboration with NHS England and NHS Improvement and a cross-speciality clinical group, supported by the specialist societies and royal colleges. NICE is using a different approach to normal to develop these quickly (hfma.to/rapid). In addition, rapid evidence reviews will look at whether certain medicines may increase the severity or length of Covid-19 illness.

Initially the body is reviewing:

• Ibuprofen and other non-steroidal anti-inflammatory drugs used to reduce temperature and ease flu-like symptoms
• Angiotensin converting enzyme (ACE) inhibitors used to treat high blood pressure or heart failure.

NICE will also be working with the Medicines and Healthcare Products Regulatory Agency to facilitate rapid review of information and advice on the safety and efficacy of treatments for Covid-19.

Gary Shield is resource impact assessment manager at NICE