ABSTRACT
The British National Health Service (NHS), which was established in 1948, was the "first health system in any Western society to offer free medical care to the entire population through a state-provided, comprehensive service funded largely from national taxation". The Labour government's response was to increase the "National" in the NHS. National Institute for Clinical Excellence's (NICE) implicit political goal was to screen ministers from decisions about rationing resources, although the government and NICE itself tended to use terms such as hard choices, prioritization, and that other "R" word, rational, rather than rationing. The Department of Health for England and NHS England decide which topics NICE will look at. NICE divides its guidance into five main areas: health technology, clinical practice, public health, social care, and quality standards. NICE has increased the volume and quality of evidence used to support key economic decisions in the NHS and has helped to reduce geographical variation in the allocation of scarce healthcare resources.
