Understanding NICE: Why guidelines matter in mental health care

By Yasmin Bou Karim, Founder of Bossa Health

Have you ever wondered how GPs, psychotherapists or psychiatrists decide on the “right” treatment or approach to care? While much depends on their experience and judgment, there is also a framework that helps guide decisions across the country. In England, this comes from NICE – the National Institute for Health and Care Excellence.

What is NICE?

NICE is a public body backed by the Department of Health and Social Care. Its role is to make sure that decisions in the NHS and other care services are informed by the best available evidence.

In simple terms, NICE creates clinical guidelines – detailed recommendations for how [mental] health conditions should be diagnosed, treated, and managed. These guidelines are meant to help health professionals give safe, effective, and consistent care.

Why do NICE guidelines matter?

NICE guidelines do not replace a professional’s knowledge or experience. Instead, they act as a foundation to support decision-making, and are built to:

• Offer clear recommendations for treatment and care.

• Set standards to measure the quality of clinical practice.

• Support training and education of health professionals.

• Give patients reliable information to make informed choices.

• Improve conversations and shared decision-making between patients and professionals.

How are guidelines created?

Creating a NICE guideline is a careful, multi-step process that aims to keep recommendations transparent, evidence-based, and practical for real-world application.

1. Choosing topics: The NHS, Department of Health, and Department for Education suggest areas where guidance is most needed.

2. Defining the scope: NICE sets out what the guideline will cover, why it is needed, and what it aims to achieve. Stakeholders (organisations or groups with an interest in the topic) can give feedback before the scope is finalised.

3. Reviewing evidence: Experts review research, carry out literature searches, and assess the impact of potential recommendations on both health outcomes and costs. If there isn’t enough research, expert opinion plays a role.

4. Committee discussions: A committee made up of professionals, carers, and people with lived experience considers the evidence and drafts recommendations.

5. Consultation: A draft guideline is shared with stakeholders for feedback. Issues such as equality and access are considered.

6. Final approval: NICE’s senior team reviews, signs off, and publishes the guideline.

7. Regular updates: Guidelines are reviewed and updated as new evidence becomes available.

Bossa Health and NICE

At Bossa Health, we see NICE guidance as a cornerstone of quality care. From the very beginning, NICE informed how we built our service – including our application to be regulated by the Care Quality Commission (CQC). The medications we prescribe, the conditions we treat, and the approaches we use are all grounded in NICE recommendations.

For us, NICE is not just a starting point but a foundation we continue to build on. By aligning with these nationally recognised standards, we can deliver care that is safe, effective, and trusted – and then take it further by finding new ways to improve the experience and outcomes for the people we support.