NICE depression advice could ‘seriously impede’ care, say experts

Leading mental health experts have challenged draft guidelines from NICE, on the grounds that they could potentially cause clinical harm.

MP Norman Lamb giving a speech

The latest National Institute for Health and Care Excellence (NICE) draft guidelines on adult depression are “not fit for purpose”, say leading mental health experts.

In a position statement to NICE, a coalition of 14 organisations, including the Royal College of Psychiatrists, British Psychological Society and charity Mind, said the draft guidelines on the Recognition and Management of Depression in Adults were underpinned by a flawed methodology, a lack of transparency and several inconsistencies.

They added that, if the guidelines were published as they were, it could “seriously impede the care of millions of people in the UK suffering from depression, potentially even causing clinical harm”.

The coalition was formed after a number of stakeholders to the NICE review process expressed concerns about the draft guidelines, which were published in July 2017.

The issue was then passed on to Norman Lamb, MP for the Liberal Democrats, and in February 2018 an Early Day Motion was tabled and 23 MPs signed a cross-party letter to NICE, asking it to respond to the stakeholders’ concerns and hold a second consultation.

After a meeting in April 2018, NICE agreed to a second four-week consultation, which ended on 12 June 2018. However, according to the coalition, the changes made were only “cosmetic” and the guidance was still not fit for purpose.

As a result, the group is now demanding a full revision of the guidelines. It has spelled out six amendments that, it says, must be undertaken before the draft is published, including conducting a proper analysis of one- and two-year follow-up data from trials and carrying out a systematic review of primary studies of service-user experience.

Mark Baker, director of the NICE centre for guidelines, said the committee planned to meet soon to review and discuss the comments received, and would be responding in due course.

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Citation
The Pharmaceutical Journal, June 2018;Online:DOI:10.1211/PJ.2018.20205039