From the rainforest to the desert: A NICE for social policy

By Sarah Keen 25 June 2012

As we covered on the blog last week, on Friday morning NPC hosted a roundtable to discuss the idea of a NICE for social policy. Attendees came from across the policy landscape—central and local government, charities, think tanks and funders—with the mix of perspectives in the room contributing to a thought-provoking discussion about what such a body would look like.

Simply put, the idea is this: could we create a body to provide independent,evidence-guidance on the most effective interventions to tackle social problems, much like the National Institute for Health and Clinical Excellence (NICE) does for healthcare? The idea has been discussed on this blog and others (see here, here and here) previously, but Friday was the opportunity for people interested in the idea to get together and discuss the embryonic design and possible implications of such a body.

There was palpable enthusiasm in the room for the idea, with the debate focusing less on whether there should be one and more on what its role would be and to what extent the context was different from that of healthcare. Could NICE, existing in the ‘rainforest’ of randomised control trials (RCTs) and the common metric of Quality Adjusted Life Years (QALYs) be lifted wholesale into the ‘desert’ of the social sector?

The common view was no, that NICE exists in an amazing ecosystem of evidence about what works,and was set up in different political and economic environment,which would make a simple replication of the healthcare body impossible. However, a number of attendees pointed out that the social sector should not think of itself as too different from the health sector, and that actually such a body could help foster a more plentiful ecosystem of evidence.

The discussion was not all gung-ho optimism. Attendees also expressed real concerns about who would fund the work charities do that is untried and untested,or cannot be easily measured. Would the new body make a binary recommendation about whether an intervention was effective or not,or would there be wiggle room for the innovative and the unknown? Would the standard of evidence be a RCT, or would other types of evidence be recognised?

On the whole,there was a realistic acknowledgement that we currently have more questions than answers,but that the idea is worth exploring further. Back at our desks,we in the measurement and evaluation team were debating whether there could be a QALY for the social sector. As those who work with charities of all shapes and sizes to help them measure their impact,we can see that the details of such a body—and its implications for charities—will need some careful thinking through. But it’s exciting to hear these kind of issues discussed,and we at NPC will be following and contributing to the debate with interest.