NHS England has identified the following interventions where comparative data on costs and benefits is available which should deliver a significant reduction in PYLL. We would recommend that commissioners give consideration to these interventions as part of work to set a local level of ambition on mortality. These are set out in two groups. For the first set in the summary table below, evidence is available that associates a particular intervention with a particular outcome.
For the second set in Annex B (the individual factsheets), there is evidence that deaths from a condition could be reduced and there is evidence concerning a range of interventions that would support this, but the evidence base does not enable us to separately identify the likely contribution of each intervention.
Whilst we have tried to ensure that the focus of this resource is on interventions with a strong evidence base, we have rated various interventions as 1, 2, 3, 4 in terms of the relative strength of the evidence base. This rating system is intended to act as a guideline only. Broadly, the criteria we have applied are:
- The intervention (and evidence) is published in both a clinical strategy and NICE Clinical Guidance;
- The intervention (and evidence) is published in a clinical strategy, but there is no NICE guidance;
- The intervention (and evidence) supported by a large-scale clinical trial;
- The intervention has been used in a single area and assessment has shown its effectiveness in that area.
It is our intention to continue to develop this resource throughout 2014 and potentially beyond, therefore in some cases holding pages have been included while work is in hand to explore a particular issue or intervention. We expect to periodically update the contents of this resource.
The following table sets out comparative information relating to the relative costs and benefits of a range of interventions. Comparative information is not yet available for all the interventions referred to in this resource. We are very grateful to the National Cardiovascular Intelligence Network, Public Health England, for their assistance in producing this information.