Guidelines on the management of RA

There are useful guidelines in place for various aspects of rheumatoid arthritis from different healthcare bodies. These guidelines offer evidence-based ‘best practice’ models.

The National Institute for Health and Care Excellence (NICE) was founded in 1999 to create consistent clinical guidelines and make sure that people across England and Wales have equal access to treatment regardless of where they live. NICE Guidelines apply in England and Wales.

In Northern Ireland NICE guidelines are reviewed when they are published and, after considering any local issues relating to implementation in NI, will decide whether to endorse their use locally. As a result, NICE guidelines can take longer to be applied in practice in NI than in England and Wales.

In Scotland, the Scottish Medicines Consortium (SMC) has a similar role to NICE. Although NICE and SMC often reach the same decision, this is not always the case. Some treatments may be recommended by either NICE or SMC, but not both.

NICE produces several types of guidelines, which are put together by experts in the subject area, people who use services, carers, and members of the public:

  • Technology Appraisals, which look at whether new treatments are both effective and value-for-money for the NHS – for example, when a new advanced therapy becomes available, NICE will publish a technology appraisal which recommends whether or not it should be used in the NHS.
  • Clinical guidelines, which recommend the care and services that are suitable for most people with a specific condition or need, such as RA. They may also recommend ways to promote and protect good health, how to set up and provide health and social care services, or how different organisations can work together to improve the quality of care they offer.
  • NICE also produce other guidelines on new diagnostic technologies, interventional procedures, highly specialised technologies and new medical devices.
  • Clinical Guidelines and Technology Appraisals are developed using the best available evidence. They all go through the same process to make sure that the guidelines are up-to-date, credible, robust, and relevant.

A Technology Appraisal can say that one or more particular technologies (for example, certain medicines) are, or are not, recommended as an option for treating a condition such as RA They often recommend that the new medicine should only be used after other treatments have been tried, or if the patient has a severe condition.

To find out more about NICE guidelines, visit

Full details of the NICE guidelines adopted in Northern Ireland are on the NI Department of Health website at

The SMC website is at