February 2012

Francoise Cluzeau conducted three focus groups with the World Bank in Ankara, Turkey as part of the programmatic assessment of performance based contracting scheme in Family Medicine Practice. The focus groups gathered 30 participants from various provinces in Turkey and included: Family Medicine physicians, health personnel and centre division chiefs (or deputies) from the provincial administration and Community Health Centres.

Helping develop a clinical guideline in Turkey

April 2009 – June 2010

NICE International is helping the Turkish Ministry of Health (MoH) develop a short clinical guideline on Caesarean section (Decisions and outcomes of a planned caesarean section in the absence of a clinical indication). This work is a pilot project and it forms part of the MoH strategic plan for the implementation of the Health Transformation Program in Turkey.

The work is coordinated by the General Directorate of Health Education at the MoH. A local technical team of systematic reviewers and health economists provides technical support to a Guideline Development Group of expert clinicians, including obstetricians, neonatologists, community/primary care doctors, midwives, and patients. NICE provides hands-on technical assistance and training to the Turkish team and the Guideline Development Group throughout the development of the guideline. The project runs until June 2010 and the guideline is planned to be published on the 1 July 2010.

Helping develop guidance on Caesarean section in Turkey

February 2011

On 24 February the Georgian Ministry of Labour Health and Social Affairs (MOLHSA) launched the Georgian Clinical guideline on the diagnosis and initial management of acute stroke & transient ischaemic attack (TIA). The event was introduced by the deputy Minister Mr. David Lomidze and Director of Health Dr. Rusudan Rukhadze.. The guideline was adapted from the NICE guideline (CG68) and was developed collaboratively with NICE International. A Quick Reference Guide and Patient document have also been produced as well as a Guidelines manual for Georgia.

Dr Rusudan said the development and implementation of clinical guidelines and protocols is essential for Georgia, especially in the context of the health care reforms, building of new hospitals and training of health professionals. The MoLHSA is working closely with the insurance companies and donor organisations to implement this guideline and to improve the quality of care and services for the all Georgian citizens.

Raising awareness of sustainability in care programmes amongst Georgian policy makers

October 2010

The purpose of the workshop was to inform thinking at senior government and managerial level for the institutionalization of a high-quality, realistic and sustainable quality care programme (including clinical guidelines) in Georgia, drawing on NICE’s experience of working in the UK and other countries and the early lessons emerging from the MoLHSA-NICE collaboration.

The workshop was opened by the Deputy Minister of Health, Dr Misha Dolidze, and brought together over thirty participants representing the health insurance, professional associations, providers and the private sector, other government departments, universities, as well as IFIs such as the World Bank.

The workshop was led by a UK team, comprising a non-executive member of the NICE Board (who acted as workshop chair), the Director of the National Collaborating Centre for Mental Health at NICE, the NICE International lead for the Georgia project and the Director of NICE’s International Division, in collaboration with the Georgian team, including senior policy makers and clinicians involved in the broader MoH/NICE project. The project is funded by the World Bank.

The day combined formal presentations drawing on NICE’s experience of evidence-based practice and interactive discussions focusing on the Georgian health policy context The first part of the day focused on how to improve Georgian healthcare by developing evidence-based guidelines and using national Quality Standards appropriate to the Georgian healthcare system, and how these may be used in commissioning, reimbursing and regulating the healthcare systems in Georgia. The second part of the workshop drew more specifically on the institutionalisation of guideline development and health quality improvement in Georgia and what would be needed to ensure sustainability.

Piloting clinical guideline development in Georgia

May 2010

As an initial phase of the project and to help build technical capacity, a NICE consultant delivered a ten-day introductory course on systematic review. The course was attended by staff from the Ministry of Labour, Health and Social Affairs, clinicians and other technical personnel.

March 2010

NICE International signed a memorandum of understanding with the Ministry of Labour, Health and Social Affairs (MoLHSA) of Georgia. This sets out cooperation between NICE and the Georgian Ministry in aspects related to the improvement of quality and access to health care in Georgia through the development of evidence-based clinical guidelines on the management of high priority diseases.

Building on this, NICE International and the MoLSHA are working on a collaborative project to develop a clinical guideline for Georgia. The project runs from April 2010 to December 2010. The aim is to help build local capacity, through hands-on training in adaptation of an existing NICE guideline to the Georgian setting with the active input from Georgian health professionals, policy makers, academics, service users, health insurance and industry.

The project involves the following objectives:

• Help build some of the necessary strategic and technical expertise to support the development and application of evidence-informed standards in day-to-day policy and practice in Georgia and identify key areas where further capacity building is needed.
• Develop/strengthen the framework – including structures, methods and processes – for adapting an evidence-based clinical guideline and implementation support documents in the Georgian healthcare setting, using an existing NICE guideline and the underlying evidence base, as the starting point.