Podcast - NICE News - September 2026

The video version of this podcast can be found here:

·       https://youtu.be/djfeYkbyoYU

This episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE.

NICE stands for "National Institute for Health and Care Excellence" and is an independent organization within the UK healthcare system that produces evidence-based guidelines and recommendations to help healthcare professionals deliver the best possible care to patients, particularly within the NHS (National Health Service) by assessing new health technologies and treatments and determining their cost-effectiveness; essentially guiding best practices for patient care across the country.

My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I go through new and updated recommendations published in September 2026 by the National Institute for Health and Care Excellence (NICE), focusing on those that are relevant to Primary Care only.

I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement.  

Disclaimer:

The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions.

In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido.

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• Music provided by Audio Library Plus 
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Tracks:

00:00 – Introduction and welcome

00:25 – Suspected sepsis

02:13 – Psychosis and schizophrenia

04:04 – KardiaMobile 6L

05:38 – Thank you and good-bye

There is a podcast version of this and other videos that you can access here:

Primary Care guidelines podcast:

·       Redcircle: https://redcircle.com/shows/primary-care-guidelines

·       Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK

·       Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148

There is a YouTube version of this and other videos that you can access here: 

• The Practical GP YouTube Channel: 

https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk

The Full NICE News bulletin for September 2026 can be found here:

·       https://www.nice.org.uk/guidance/published?from=2026-09-01&to=2026-09-30

The updated NICE guideline on Suspected sepsis in people aged 16 or over: recognition, assessment and early management [NG253] can be found here:

·       https://www.nice.org.uk/guidance/ng253

The updated NICE clinical guideline on Psychosis and schizophrenia in adults: prevention and management [DG178] can be found here:

·       https://www.nice.org.uk/guidance/cg178

The updated NICE Health Tech guidance on KardiaMobile 6L for measuring cardiac QT interval in adults having antipsychotic medication: early value assessment [HTG694] can be found here:

·       https://www.nice.org.uk/guidance/htg694

Transcript

If you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the episode description.

Hello and welcome! I’m Fernando, a GP in the UK. In today’s episode, we’ll look at the NICE updates published in September 2026, focusing on what is relevant in Primary Care only.

If you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the episode description.

Hello and welcome! I’m Fernando, a GP in the UK. In today’s episode, we’ll look at the NICE updates published in September 2026, focusing on what is relevant in Primary Care only.

This month, we have brief updates in two areas: suspected sepsis, and psychosis and schizophrenia, including QT interval monitoring in people taking antipsychotic medication.

Right, let’s jump into it.

Let's start with the updated NICE guideline on suspected sepsis in adults.

The main change is that NICE has updated its recommendations on procalcitonin testing.

And let’s remember that procalcitonin is a blood biomarker that tends to rise in bacterial infection and sepsis, and it can help estimate the likelihood of bacterial infection.

However, NICE does not recommend procalcitonin testing in primary care, so these updated recommendations mainly relate to hospital care.

So, what are the main messages for us in primary care?

The first is simple: we should think about sepsis early whenever someone has a possible infection and appears significantly unwell.

Let’s also remember that sepsis can present non-specifically, that the patient may not have a fever, and that we should be particularly careful when the history is difficult to obtain, for example because of communication difficulties, cognitive impairment, learning disability, etc.We should also refer suspected neutropenic sepsis immediately for hospital assessment.

The second point is structured assessment.

In hospital and ambulance settings, NEWS2 is used to assess adults with suspected sepsis who are not pregnant and have not recently been pregnant.

However, in general practice, we may not always formally calculate NEWS2, but the principle is the same: we should assess physiology, including respiratory rate, oxygen saturation, heart rate, blood pressure, temperature, level of consciousness and overall clinical concern.

And the third main message is escalation and safety-netting.

If the patient has high-risk features, we should arrange emergency transfer to hospital, usually by 999 ambulance, and pre-alert secondary care.

Let's now look at the updated NICE guideline on psychosis and schizophrenia in adults.

For us in primary care, this update is unlikely to change routine practice, because it relates to rapid neuroleptisation in secondary care.

Rapid neuroleptisation refers to the use of repeated doses of antipsychotic medication over a short period to quickly control severe agitation.

So, what are the main messages here for us in primary care?

First, we should refer early if we suspect emerging psychosis.

And if someone presents with sustained psychotic symptoms for the first time, we should not start antipsychotic medication in primary care unless this is done in consultation with a consultant psychiatrist.

Second, we should take physical health monitoring very seriously.

People with psychosis or schizophrenia, especially those taking antipsychotics, have a higher risk of physical health problems. This is important because cardiovascular disease and metabolic disease are major contributors to reduced life expectancy in people with severe mental illness.

Some antipsychotics can cause weight gain, worsen glucose control, increase the risk of diabetes, affect lipids, raise prolactin, cause movement disorders, and prolong the QT interval.

So, once monitoring responsibility is transferred from secondary care, we should do at least annual physical health checks and cardiovascular risk assessments, including weight, waist circumference, pulse and blood pressure, HbA1c, lipids, lifestyle advice including smoking, diet, and physical activity.

We will also enquire about possible movement disorders and check prolactin where relevant.

And this area links quite nicely with another updated NICE HealthTech guidance on KardiaMobile 6L for QT interval monitoring in adults taking antipsychotic medication.

First, what is KardiaMobile 6L?

It is a small portable ECG device that records a 6 lead ECG using electrodes placed on the fingers and left leg or ankle.

Unlike a standard 12 lead ECG, it is designed as a quick point of care test and can estimate the QT interval, helping identify people at risk of drug induced QT prolongation.

The guidance supports KardiaMobile 6L as an option for QT interval measurement in adults taking antipsychotic medication, while further evidence is generated, and it should be used alongside standard clinical assessment.

It is intended to improve access to QT monitoring and reduce the need for conventional 12 lead ECGs in suitable patients.

For us in primary care, the overall approach remains unchanged.

We should continue to assess risk factors, including electrolyte abnormalities, structural heart disease, interacting medicines and previous prolonged QT interval issues.

If ECG monitoring is required, local pathways may increasingly use portable technologies such as KardiaMobile 6L, but abnormal or uncertain results still require clinical interpretation and perhaps confirmation with a standard 12 lead ECG.

So that is it, a review of the NICE updates relevant to primary care.

We have come to the end of this episode.

Remember that this is not medical advice, but only my summary and interpretation of the guidelines.

You must always use your clinical judgement.

Thank you for listening and goodbye.