‘Demand full revision of NICE guidance on Depression’

Last week a News article in the BMJ outlined that a “coalition of mental health organisations and individual clinicians has described the latest draft guidelines on adult depression by the National Institute for Health and Care Excellence (NICE) as misleading, invalid, and not fit for purpose, saying that they could harm patients. Fourteen organisations including the Royal College of Psychiatrists and six leading doctors including Simon Wessely, former president of the college, and Clare Gerada, former president of the Royal College of General Practitioners, have signed a position statement sent to NICE.”

I submitted the following rapid response to the BMJ last week but it has not been published. I suspect this is because I included a verbatim quote by a member of this group.

The quote beginning “I don’t I am afraid agree …” was made in correspondence to me by Professor Sir Simon Wessely. I did not reveal this in my submission to the BMJ.

By Dr Peter J. Gordon, 20 June 2018

I have followed what I can of this development since reading an article that explained some of the backdrop to this unusual late stage development. In this article reference was made to an open letter which began:

“along with many other stakeholders, we are extremely concerned about significant flaws in methodology, lack of transparency and inconsistencies in the document.”

Interested to find out more, I wrote to NICE Seeking further clarification on this development. NICE outlined that they had offered a meeting to the “authors of the 17th November letter to discuss their concerns with them”. The meeting apparently took place on 27th April and following this “NICE decided to run a second consultation.”

I asked NICE where the public could access the minutes of this meeting and was informed that “the meeting on 27th April was not minuted or otherwise recorded.”

Given the call for transparency by this group I was most disappointed to find this. I therefore wrote to one of the signatories of the letter asking if any informal minutes of this meeting with NICE could be shared. I received this reply: “I don’t I am afraid agree that you have any right to see any of minutes, any more than you would have any rights to hear a transcript of a conversation I had yesterday with a bloke in the pub about some recent NICE guideline and what we should do about it.”

I note that this group is now being described as “campaigners and doctors” whereas initially this group was described as “experts”. It might be that all the recommendations of this “group” (however termed) will indeed make the treatment guidelines for depression “fit for purpose”. However, as it stands, it is difficult to follow exactly what is going on.

National treatment guidelines could apply to any one of us. Given that one of the key concerns of this group related to transparency it is disappointing to find that this has not been equally applied.


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