These are the main stages in the multiple technology appraisal process used before April 2018.
It applies to evaluations that started before 1 February 2022.
In April 2018, following the publication of our new methods, processes and topic selection manuals, we implemented a new MTA process. The new manuals apply to evaluations that began after this date.
We invite relevant stakeholders (known as consultees and commentators) to take part in the appraisal and to nominate clinical, commissioning and patient experts.
We ask consultees to submit any relevant information about the topic.
They have 14 weeks to send in their submissions.
Organisations can apply to become a consultee or commentator at any point in the process.
Key information added to our website
We add the remit, scope and a list of consultees and commentators to the website.
The remit is the brief for the appraisal. The scope sets out what the technology appraisal will cover and the questions that need to be addressed.
Stakeholder information meeting (SIM) may be held
All consultees and commentators can send up to 2 representatives to the meeting.
Deadline for the receipt of consultee submissions
Evidence review begins
We send the consultee submissions to an independent academic centre (called the Assessment Group).
They use the consultee submissions to help write the assessment report on the clinical and cost-effectiveness of the technology(ies).
We invite the selected clinical, commissioning and patient experts to attend the appraisal committee. We ask them to submit a statement on the technology and how it should be used in the NHS in England.
Assessment Group report received by NICE
Assessment report sent to the consultees and commentators for comment
Assessment report published on our website for information
Deadline for receipt of the expert statements
Deadline for the consultee and commentator comments on the assessment report
Key documents sent to the appraisal committee
The appraisal committee is an independent advisory committee that makes recommendations.
We send attendees:
- the assessment report and any comments
- the AG's response to comments on the assessment report
- submissions from the professional, patient/carer and NHS commissioning consultees
- summaries of the company submissions (full submissions are available to the Committee)
- a pre-meeting briefing written by NICE's technical lead for the appraisal.
We don’t send the papers to any members of the public who have registered to attend the meeting.
Appraisal committee meets to consider the evidence
We hold an appraisal committee meeting to consider the committee papers and hear from nominated clinical, patient and NHS commissioning experts.
The committee will decide to develop an appraisal consultation document (ACD) or final appraisal document (FAD).
The ACD contains the draft recommendations from the Appraisal Committee. The FAD is the final draft of the guidance and includes the committee's final recommendations.
We produce an ACD when the recommendations from the Appraisal Committee don’t recommend
useof the technology,or limit the use of the technology beyond the specifications in the marketing authorisation.
If an ACD isn’t needed we move straight to developing the final appraisal document (FAD) (see week 42).
Part 1 of this meeting is open to members of the public and press.
Appraisal consultation document (ACD) and supporting documents sent out for comment
Consultees and commentators have 20 working days to submit their comments on the draft recommendations.
Public consultation on the ACD
The ACD and supporting documents are published on the website for comment. The consultation is open for 15 working days.
Anyone can submit comments during consultation.
Public consultation on the ACD ends
Appraisal committee meet to develop the FAD
The Appraisal Committee considers the comments received on the ACD, then makes its final recommendations on how the technology should be used in the NHS in England. This is the FAD.
Part 1 of the meeting is open to members of the public and press.
Guidance issued (if no ACD)
If no ACD was produced and no appeals have been received, the topic is published.
This is the earliest possible point that final guidance can be issued.
We publish the FAD and supporting documents on the website for information.
Technology appraisal publishes
If there are no appeals the final recommendations are issued as NICE guidance.
The technology appraisal is published on the NICE website. Registered stakeholders are notified by email.
When the guidance is published we give a date for it to be reviewed. This is when we consult with relevant organisations about whether the guidance needs to be updated.