ABSTRACT
In 2005, NICE took on the responsibility for public health interventions, transferring responsibilities and staff from the Health Development Agency in a continuing process of expansion and consolidation. Public health brought with it big debates about, in particular, the evidence for focussing on the ‘upstream’ prevention of illness: whether it is best to concentrate on the social determinants of health such as taxes on sugary drinks, or on individual responsibility, with dietary advice. NICE became both battleground and participant in ‘evidence wars’ about what worked, how that was demonstrated, and what standard of proof was needed for action.
An equally important step in NICE’s expansion and consolidation was the addition of responsibility for social care interventions in 2013. This necessitated NICE ‘leaving the NHS’, at least in legal terms, changing from an NHS body to a ‘Non-Departmental Public Body’. The social care sector is larger than, and markedly different from, the NHS, calling on NICE to develop new approaches to evidence, relationships with new delivery organisations and different kinds of service users.
