n-of-1 trials

A type of clinical trial in which the patient undergoes pairs of treatment periods such that one period involves the use of the experimental treatment and the other involves the use of an alternative. Treatment periods are replicated until the triallist is convinced that the treatments have different outcomes (or not, as the case may be).

Acronym for new active substance. Nash Equilibrium

A concept used in game theory and, in particular, non-zero-sum games. A Nash equilibrium is a set of strategies such that no player can benefit by changing their strategy while the other players keep theirs unchanged. Named after John Nash, the mathematician and game theorist (b. 1928), he of the 'beautiful mind'.

National Coordinating Centre for Health Technology Assessment

The (England and Wales) centre through which the Health Technology Assessment Programmes of the government's Department of Health are coordinated. Its website is at www.ncchta.org/.

National Health Service

The common name given to the health care systems of the four countries in the United Kingdom (England, Wales, Scotland and Northern Ireland). Although broadly similar, there are variations in the administrative and managerial arrangements between them and in their funding levels.

226 National Income

National Income

Same as net national product.

National Institute for Health and Clinical Excellence

The Institute (NICE) is a statutory National Health Service (NHS) organization for England and Wales whose principal jobs are to identify and recommend cost-effective health care technologies and develop authoritative clinical guidelines which include economic criteria. It also conducts confidential enquiries into deaths of people in the care of the NHS. It is probably unique in living up to the promise of its acronym. It acquired 'Health and' in its title in 2005 but its acronym remains NICE. Its web site is http://www.nice.org.uk/.

National Service Framework

This is a planning mechanism used in the UK National Health Service to set national standards and define service models for a service or care group, to put in place programmes to support implementation and to establish performance measures against which progress within agreed timescales can be measured. They currently (2004) cover five key areas: cancer, coronary heart disease, diabetes, mental health and older people.

National Tariff

A list of prices per Healthcare Resource Group used in commissioning health care in the internal market of the English National Health Service.

Natural Rate of Unemployment

The rate of unemployment that is (just) consistent with a zero inflation rate. Although there may be nothing 'natural' about it, it does appear to be determined by factors outside the conventional fiscal and monetary instruments of government (for example, customary employer and trade union practices). Deregulation and greater flexibility of working practices are argued to be some means by which the natural rate might be reduced. Also sometimes called the 'non-accelerating inflation rate of unemployment' (NAIRU), which does not carry the unfortunate implication of inevitability suggested by 'natural'.

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