National Institute for Health and Care Excellence

Could you talk to us a little bit more about what CBT is and how it could help during IVF?

Yes, so CBT is recognised by NICE, the National Institute of Clinical Excellence, as a treatment for particularly anxiety and low mood, but other things as well.

It's one of the most sort of evidence-based interventions that we have.

It's not for everybody, but for a lot of people it can help.

Parveen Kumar, we've talked about your textbook, but you have had so many major roles in medicine.

You've been president of the British Medical Association, a former president of the Royal Society of Medicine, founding non-executive director of the National Institute for Care Excellence, NICE.

And that's not even a complete list.

I mean, I'm missing a few key roles off.

And I took it home and I did it.

And if you haven't got time to watch all of this video and to learn about what I consider to be the relatively ridiculous guidelines from my National Institute for Health and Care Excellence, the people that make up.

how doctors operate in the UK.

We'll talk about that towards the end.

So this is what it says in the NICE guidelines.

Now I'm just going to go through these so we can see exactly what the position is.

Now this is from the National Institute for Health and Care Excellence.

So these guidelines are obviously excellent.

And I went to one of her courses where she talked about managing childhood fevers.

And she just quoted the NICE guidelines, which the National Institute of Clinical Excellence guidelines on managing fevers for under fives.

And it specifically says, do not use antipyretic agents with the sole intention of reducing the fever.

And it was kind of mind blowing.

We hope you enjoyed this episode.

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Yeah, so if we consider autism specifically, a diagnosis doesn't automatically enter you into formal support, like you said.

There should be a follow-up, so the NICE guidelines, which is the National Institute for Health and Care Excellence in England, Wales and Northern Ireland.

They set the standards for like health care and treatments, but they say that you should be given a key worker and a personalized plan for support needs.

So I'm just outlining this in case it's helpful.

But the only female obstetricians I've ever seen do it are ones who didn't themselves have children, which I think is kind of interesting.

So really, what is the story with regards to high blood pressure and the use of epidurals to reduce high blood pressure? Because epidurals are known to reduce blood pressure, so are they sometimes clinically indicated? Well, let's look at the gold standards, which are the NICE guidelines.

That's the National Institute for Health and Care Excellence.

And these are the gold standards recommended for all around the world, even though so many obstetricians choose not to follow them and sometimes midwives.

Okay, so I'm going to look at my notes here because I want to read this out to you.

There is an important distinction between the physiological effect of an epidural which may lower maternal blood pressure and an evidence-based clinical indication for recommending one.

NICE does not recommend epidural analgesia solely to reduce mild maternal hypertension during labor.

Mild hypertension in isolation is not a NICE clinical indicator for recommendations of epidurals as an antihypertensive intervention.