Why is it nice to be nice? You ask. A lot of people have asked me that question over the years and I have always found the answer very strange. The real answer is a little strange too – although it makes sense to a degree. The answer is that it makes sense because human beings are naturally nice to each other and there are lots of social rules that we all understand. Those rules do not allow you to be mean to other people; rather they tell you that being nice is socially acceptable.

The National Institute for Health and Care Excellence (NICE) is an independent executive body of the United Kingdom government, which produces guidelines in four disciplines: public health, medical practice, clinical practice and community health. It also publishes a report on treating patients with integrated care. In its 2007 report, “pects of Efficient Social Care”, the independent organization recommended that health service users were encouraged to adopt certain practices that would contribute to their cost-effectiveness. The four areas that NICE recommended to be covered in that report were:

Appraisal – this is a process by which people’s value and worth are judged against different scenarios. This may be done on a case by case basis or on a permanent scale through a formal appraisal. The importance of appraisal is that it provides the client with information about his or her clinical trials, surgeries, diagnostics, treatments and so on. It enables the provider to make changes to the services and improve the quality of life of the client in the best possible manner. If the health care provider is nice, he or she will be perceived as good and valuable.

Assessment – this involves asking questions, observing or being given information on the condition of a person, doing a physical examination or doing a work profile. Assessment also involves gathering information from the client, the family and others. There is a big difference between giving decision making and giving assessments. Decision making requires research, whereas assessments only require gathering information.

Monitoring and Interventions – this refers to either interventions at the beginning of the care period (monitoring) or at the end of it (interventions). These could be done formally by the attending physician or formally by the client or care giving team. These involve different types of interventions. In cases of medical interventions, they are usually done in the operating room or in the recovery area. In case of clinical guidelines, they are done once all the documentation has been collected.

Support – any kind of support from the service provider can be called for either in-services or out-sides. Care giving teams in clinical guidelines often ask the patient, family, relatives or care givers to provide informal support in the form of notes, support letters, emails or calls. Even the hospital personnel get such support. Patients find such forms of informal support refreshing and give them hope that they are doing something right. Tim Riley calls these informal supports nice.