NICE Guidelines 2026: New and Updated Guidelines

The 22 guidelines at a glance, most recently changed first

Suspected sepsis (16 and over)NG253
Multiple sclerosisNG220
EpilepsiesNG217
Acne vulgarisNG198
MASLD (fatty liver disease)NG49
Low back pain and sciaticaNG59
Osteoporosis risk assessmentNewNG259
Heavy menstrual bleedingNG88
Ectopic pregnancy and miscarriageNG126
Postnatal careNG194
Intrapartum careNG235
Anaphylaxis after emergency treatmentNewNG258
Neonatal infectionNG195
Suspected cancer referralNG12
MenopauseNG23
Fertility problemsNewNG257
Fetal monitoring in labourNG229
Kidney cancerNewNG256
Blood transfusionNG24
Hypertension in adultsNG136
Type 2 diabetes in adultsNG28
Overweight and obesityNG246

NICE sepsis and emergency care guidelines

Suspected sepsis in people aged 16 or over: recognition, assessment and early management

NICE guideline NG253·Updated September 2026

NG253 covers the recognition, diagnosis and early management of suspected sepsis in people aged 16 or over who are not, and have not recently been, pregnant, including early assessment, initial treatment, escalating care, finding and controlling the source of infection, monitoring, and training. On 23 September 2026 NICE updated recommendations 1.8.2 and 1.8.16 after reviewing the evidence on procalcitonin (PCT) testing; the new content is marked [2026]. In the same update it aligned the labelling of its risk levels with the levels used in NEWS2. In January 2026 the wording was changed to 'learning disabilities' instead of 'learning difficulties'. NG253 was first published in November 2025 and partially updates and replaces NICE guideline NG51 from 2016.

View the guideline on the NICE website

Anaphylaxis: assessment and referral after emergency treatment

NICE guideline NG258·New, May 2026

NG258 is a new guideline, published in May 2026, on the assessment and referral of people with suspected anaphylaxis after emergency treatment. It covers documenting suspected anaphylaxis, the timing of blood samples, the period of observation, admission to inpatient care, referral to a specialist allergy service, and discharge from A&E or inpatient care. The recommendations on observation and admission are based on the Resuscitation Council UK's 2021 emergency treatment of anaphylaxis guideline, and recommendation 1.1.15 on adrenaline auto-injectors follows MHRA safety guidance and the guidance of the Resuscitation Council UK and the British Society for Allergy and Clinical Immunology. It updates and replaces NICE clinical guideline CG134 from December 2011. In a June 2026 surveillance review NICE decided not to update the recommendations on measuring mast cell tryptase in children under 16 or the evidence on intranasal adrenaline.

View the guideline on the NICE website

Blood transfusion

NICE guideline NG24·Updated February 2026

NG24 covers assessing the need for, and managing, blood transfusion in adults, young people and children aged 1 year and over, as general principles rather than condition-specific advice. In February 2026 NICE reviewed the evidence and made new recommendations on using tranexamic acid during surgery. That is the only change in 2026. The guideline does not cover transfusion, or the use of tranexamic acid for surgery, during pregnancy and labour. First published in November 2015, it covers reducing the need for transfusion in surgery and the transfusion of red cells, platelets, fresh frozen plasma, cryoprecipitate and prothrombin complex concentrate, plus patient safety and information.

View the guideline on the NICE website

NICE epilepsy and multiple sclerosis guidelines

Multiple sclerosis in adults: management

NICE guideline NG220·Updated August 2026

NG220 covers diagnosing and managing multiple sclerosis in people aged 18 and over, from symptom management and relapse treatment to comprehensive reviews. In August 2026 NICE withdrew its recommendation on fampridine, because NHS England now has a clinical commissioning policy on prolonged-release fampridine for walking impairment in adults with MS, and the guideline links to that policy instead. In June 2026 the diagnosis recommendations were updated to refer to the revised 2024 McDonald criteria instead of the 2017 criteria, marked [2022, amended 2026]. NICE also removed a recommendation that MS should not be diagnosed on MRI findings alone, because the 2024 criteria allow this in some circumstances. The guideline refers to NHS England commissioning policies; in Wales and Northern Ireland the local commissioning positions apply.

View the guideline on the NICE website

Epilepsies in children, young people and adults

NICE guideline NG217·Updated August 2026

NG217 covers diagnosing and managing epilepsy in children, young people and adults in primary and secondary care, and referral to tertiary services. In August 2026 NICE searched for new evidence on treatments for self-limited epilepsy with centrotemporal spikes and reviewed the licensing position after sultiame was licensed in the UK in January 2025. No new evidence was found, so an expert working group agreed the changes to the recommendations, which are marked [2026]. The previous change, in January 2025, brought the recommendations on valproate and topiramate in line with MHRA guidance, including that valproate must not be started in anyone younger than 55 unless two specialists independently document that no other treatment is effective or tolerated. NG217 was first published in April 2022.

View the guideline on the NICE website

NICE osteoporosis, back pain and acne guidelines

Acne vulgaris: management

NICE guideline NG198·Updated August 2026

NG198 covers managing acne vulgaris in primary and specialist care, including topical and oral treatments, physical treatments, and the effect of acne on mental health. In August 2026 NICE withdrew the recommendation on triamcinolone acetonide injections after a surveillance review, and updated references to polycystic ovary syndrome, which by global consensus is now called polyendocrine metabolic ovarian syndrome (PMOS). In April 2026 recommendations 1.5.19 and 1.5.20 were amended to remove the requirement for two independent healthcare professionals to approve isotretinoin in people under 18, because the MHRA has replaced that regulatory requirement with other risk minimisation measures; the links to MHRA safety advice and the acknowledgement of risk form were updated. On 28 September 2026 NICE completed a further surveillance review and decided not to update the section on managing acne. NG198 was first published in June 2021.

View the guideline on the NICE website

Osteoporosis: risk assessment

NICE guideline NG259·New, July 2026

NG259 is a new guideline, published in July 2026, on assessing the risk of fragility fractures in adults. It covers who should be assessed, the risk assessment methods and tools to use in all NHS settings, identifying vertebral fragility fractures, treatment criteria, and when and how to repeat the assessment in people who are not having treatment. It updates NICE clinical guideline CG146 from August 2012. NICE has already announced the next update, which will add risk assessment for people with a learning disability, treatment with medicines, exercise, calcium and vitamin D, and the monitoring and pausing of treatment. That update will incorporate a NICE multiple technology appraisal of medicines for osteoporosis and fragility fracture prevention that is due to publish in June 2027.

View the guideline on the NICE website

Low back pain and sciatica in over 16s: assessment and management

NICE guideline NG59·Updated July 2026

NG59 covers assessing and managing low back pain and sciatica in people aged 16 and over, including physical, psychological, pharmacological and surgical treatments. In July 2026 NICE withdrew the recommendations on psychological therapy for low back pain with or without sciatica, and on combined physical and psychological programmes. NICE's prioritisation board did not select these areas for update because it did not expect a review to lead to significant changes in practice; the surveillance decision and the 2026 board summary give the details. References to psychological therapy were also removed from recommendation 1.1.3 on risk stratification and 1.2.7 on manual therapies. The 2020 recommendations on drug treatment for sciatica and on opioids are unchanged.

View the guideline on the NICE website

NICE diabetes, hypertension and obesity guidelines

Metabolic dysfunction-associated steatotic liver disease (MASLD): assessment and management

NICE guideline NG49·Updated July 2026

NG49 covers how to identify the adults, young people and children with metabolic dysfunction-associated steatotic liver disease who have advanced liver fibrosis and are most at risk of complications, and the diet, physical activity and drug treatments that manage the condition. In July 2026 NICE renamed the guideline to follow the new international terminology: MASLD replaces non-alcoholic fatty liver disease (NAFLD) and MASH replaces non-alcoholic steatohepatitis (NASH). References to 'fatty liver' in the section on diagnosing children and young people became 'steatosis of the liver', and the wording of the healthy living recommendations was tidied. The recommendations themselves were not changed by the renaming. NICE has checked the guideline and is now updating its content; progress is on the guideline in development page.

View the guideline on the NICE website

Hypertension in adults: diagnosis and management

NICE guideline NG136·Updated February 2026

NG136 covers the diagnosis and treatment of primary hypertension in people aged 18 and over, including people with type 2 diabetes, with the aim of reducing heart attacks and strokes. In February 2026 NICE added recommendation 1.2.11: offer advice on healthy living to people who have raised blood pressure but have not been diagnosed with hypertension. This is the only change in 2026; the recommendations on measuring blood pressure, diagnosis, treatment steps 1 to 4 and blood pressure targets are unchanged since the November 2023 update on postural hypotension. NICE says it is monitoring ongoing research on how people from different ethnic groups respond to antihypertensive drugs, and will decide whether to update the guideline once that evidence is published. Hypertension in pregnancy has its own NICE guideline and is not covered here.

View the guideline on the NICE website

Type 2 diabetes in adults: management

NICE guideline NG28·Updated February 2026

NG28 covers the care of adults with type 2 diabetes: education, dietary advice, cardiovascular risk, blood glucose management and the long-term complications. In February 2026 NICE reviewed the evidence on glucose-lowering medicines, for people with no relevant comorbidities and for people with common comorbidities, and made new or updated recommendations on metformin, SGLT-2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors, sulfonylureas and pioglitazone, marked [2026]. The insulin recommendations were changed without an evidence review, because insulin products have been withdrawn and some brands are in short supply. The HbA1c target recommendations now refer to an initial medication regimen rather than a single drug, and the recommendations on introducing and reviewing medicines follow the new medicine pathway. NICE also added links to its overweight and obesity guideline and to the NHS Type 2 Diabetes Path to Remission Programme, and now writes 'living with overweight' rather than 'being overweight'. For blood pressure in type 2 diabetes it refers to its hypertension guideline, NG136.

View the guideline on the NICE website

Overweight and obesity management

NICE guideline NG246·Updated January 2026

NG246 covers the prevention and management of overweight, obesity and central adiposity in children, young people and adults, and brings together all of NICE's earlier guidelines on the subject; it does not cover pregnancy. In January 2026 NICE amended recommendations 1.10.5, 1.10.10 and 1.10.11, and their rationale sections, to clarify that the waist-to-height ratio should only be used to classify the degree of central adiposity in children and young people aged 5 years and over. Nothing else in the guideline changed. In practice this means the ratio is not used to classify central adiposity in children under 5. The guideline itself was first published in January 2025 and is NICE's single current reference for weight management across all ages.

View the guideline on the NICE website

NICE women's health, pregnancy and maternity guidelines

Heavy menstrual bleeding: assessment and management

NICE guideline NG88·Updated July 2026

NG88 covers assessing and managing heavy menstrual bleeding, from investigating the cause to choosing treatment in line with the woman's priorities. In July 2026 NICE removed recommendation 1.2.8, which said not to routinely test serum ferritin, from the section on laboratory tests. Stakeholders had questioned the 2007 recommendation, and after revisiting the evidence NICE concluded that advising against ferritin testing is not justified in this group because of the risk of iron deficiency. No other recommendation changed in 2026. Earlier changes, in 2020 and 2021, followed MHRA safety advice on ulipristal acetate (Esmya) and the risk of serious liver injury.

View the guideline on the NICE website

Ectopic pregnancy and miscarriage: diagnosis and initial management

NICE guideline NG126·Updated June 2026

NG126 covers diagnosing and managing ectopic pregnancy and miscarriage in early pregnancy, up to 13 completed weeks, in women, trans men and non-binary people with pain or bleeding. In June 2026 NICE reviewed the evidence and made new recommendations on anti-D immunoglobulin prophylaxis, marked [2026], with minor wording changes elsewhere that do not alter the meaning. The previous updates covered the medical management of miscarriage in August 2023 and progesterone for threatened miscarriage in November 2021. The guideline aims to improve how early pregnancy loss is diagnosed and how people are supported, to limit the psychological impact of the loss. NG126 was first published in April 2019.

View the guideline on the NICE website

Intrapartum care

NICE guideline NG235·Updated June 2026

NG235 covers the care of pregnant women and pregnant trans and non-binary people, and their babies, during labour and immediately after birth, for births between 37 and 42 weeks. In June 2026 NICE reintroduced recommendations on preventing vitamin K deficiency bleeding in the newborn, in the section on care of the baby after birth; the rationale and impact section on vitamin K explains the decision. The postnatal care guideline, NG194, now cross-refers to these recommendations. The rest of the guideline, including the recommendations on choosing the place of birth and on care during each stage of labour, was not changed. NG235 was first published in September 2023 and replaced the earlier intrapartum care guideline CG190.

View the guideline on the NICE website

Postnatal care

NICE guideline NG194·Updated June 2026

NG194 covers the routine postnatal care that women and their babies should receive in the first 8 weeks after birth: how postnatal care is organised, identifying and managing common and serious health problems in the woman and the baby, helping parents bond with their baby, and infant feeding. In June 2026 NICE added a recommendation, dated [2026], that cross-refers to the vitamin K prophylaxis recommendations reintroduced in the intrapartum care guideline, NG235. Nothing else changed in 2026. The vitamin K recommendations themselves are in NG235, which was updated in the same month. NG194 was published in April 2021 and replaced NICE clinical guideline CG37 from 2006.

View the guideline on the NICE website

Menopause: identification and management

NICE guideline NG23·Updated April 2026

NG23 covers identifying and managing menopause, including in people with premature ovarian insufficiency, and aims to make the support and information people receive more consistent. In April 2026 NICE amended recommendation 1.8.4 and added recommendation 1.8.5 on when to seek help for unscheduled vaginal bleeding while taking systemic HRT, so that the advice matches its suspected cancer guideline, NG12. That is the only 2026 change. The larger update was in November 2024, when NICE reviewed the evidence on cognitive behavioural therapy for menopausal symptoms, on managing genitourinary symptoms, and on the effects of HRT on specific health outcomes. NG23 was first published in November 2015.

View the guideline on the NICE website

Fertility problems: assessment and treatment

NICE guideline NG257·New, March 2026

NG257 is a new guideline, published in March 2026, on diagnosing and treating health-related fertility problems, intended to reduce variation in how they are investigated and managed. It has new or updated recommendations on the investigation of fertility problems and management strategies, ovulation disorders, tubal and uterine surgery, unexplained fertility problems, endometriosis, access criteria for IVF and the procedures used during IVF, intracytoplasmic sperm injection, and fertility preservation for medical reasons. Recommendations reviewed against the evidence are marked [2026]; others carry their original 2004 or 2013 dates. The recommendations on hypothalamic-pituitary-ovarian dysfunction, mostly polycystic ovary syndrome, were removed because NICE is developing a separate PCOS guideline. NG257 partially updates and replaces NICE clinical guideline CG156 from 2013.

View the guideline on the NICE website

Fetal monitoring in labour

NICE guideline NG229·Updated March 2026

NG229 covers monitoring the wellbeing of the baby during labour: assessing the risk to decide the level of monitoring, combining clinical assessment with monitoring, and interpreting and acting on the findings. In March 2026 NICE removed, from recommendations 1.2.9 and 1.2.10, the references to where the fetal heart rate and maternal pulse should be recorded during intermittent auscultation. The reason is practical: different patient record systems and monitoring tools record these readings in different places, and the old wording made the recommendations harder to implement. What should be measured, and when, is unchanged. NG229 was first published in December 2022. It sits alongside the intrapartum care guideline, NG235, which covers the wider care of the woman and baby during labour and birth.

View the guideline on the NICE website

NICE neonatal guidelines

Neonatal infection: antibiotics for prevention and treatment

NICE guideline NG195·Updated May 2026

NG195 covers preventing bacterial infection in healthy babies up to 28 days of corrected gestational age, treating pregnant women and pregnant people whose unborn baby is at risk of infection, and caring for babies with a suspected or confirmed bacterial infection; viral infections are not covered. In May 2026 NICE reviewed the evidence on whether the time between prelabour rupture of membranes at term and birth affects the risk of early-onset neonatal infection. It also amended the risk factors relating to fever and chorioamnionitis in box 1 because of safety concerns. New recommendations, marked [2026], set out when to switch from intravenous to oral antibiotics when treating suspected early-onset infection. The guideline aims to shorten delays in recognising and treating infection and to prevent unnecessary antibiotic use.

View the guideline on the NICE website

NICE cancer guidelines

Suspected cancer: recognition and referral

NICE guideline NG12·Updated April 2026

NG12 covers recognising children, young people and adults with symptoms that could be caused by cancer, the investigations that belong in primary care, and who to refer for a specialist opinion. In April 2026 NICE reviewed the evidence and amended recommendations 1.5.6 to 1.5.9 and 1.5.11, on the age and serum CA125 thresholds for suspected ovarian cancer, and recommendations 1.5.12, 1.5.14 and 1.5.15 on endometrial cancer. It also amended recommendation 1.13.2 on non-site-specific weight loss in adults. Recommendations on general principles of care that other NICE guidelines already cover were removed, a presentational change with no intended effect on practice. Earlier, in January 2026, an incorrect recommendation on blood tests for myeloma was removed.

View the guideline on the NICE website

Kidney cancer: diagnosis and management

NICE guideline NG256·New, March 2026

NG256 is a new guideline, published in March 2026, on diagnosing and managing renal cell carcinoma in people aged 18 and over. It covers general information for people with suspected or confirmed disease, diagnosis, the management of oncocytomas and Bosniak 2F cysts, localised and locally advanced disease, advanced disease, and heritable renal cell carcinoma predisposition syndromes. NICE names three changes to practice: every person with renal cell carcinoma should have support from a clinical nurse specialist throughout their care; clinicians should identify people with suspected disease who could benefit from a biopsy and discuss it with them; and active surveillance, thermal ablation and stereotactic ablative radiotherapy should be considered for localised small renal masses when surgery is not needed, possible or suitable. Recognising and referring suspected kidney cancer in primary care stays in NG12. NG256 was published on 19 March 2026 and will be reviewed when new evidence is likely to change its recommendations.

View the guideline on the NICE website

Ask DR. INFO about a guideline

DR. INFO answers clinical questions with the source cited in the answer, so you can check the guideline it used. Try it free.

Try DR. INFO

Questions about NICE guidelines in 2026

Which NICE guidelines are new in 2026?

Four NICE guidelines were published for the first time in 2026: NG256 on kidney cancer (March), NG257 on fertility problems (March), NG258 on anaphylaxis assessment and referral after emergency treatment (May) and NG259 on osteoporosis risk assessment (July). NG257, NG258 and NG259 replace older NICE guidelines CG156, CG134 and CG146.

Which NICE guidelines were updated in 2026?

Eighteen existing NICE guidelines were updated between January and September 2026, including NG28 type 2 diabetes, NG136 hypertension, NG12 suspected cancer, NG24 blood transfusion, NG23 menopause, NG195 neonatal infection and NG253 suspected sepsis, which was updated on 23 September 2026. The full list, with what changed in each, is above.

What changed in the NICE type 2 diabetes guideline (NG28) in 2026?

In February 2026 NICE reviewed the evidence on medicines for type 2 diabetes and made or updated recommendations for people with no relevant comorbidities and for people with common comorbidities. It also changed the recommendations on insulin because of withdrawn insulin products and known brand shortages.

What changed in the NICE hypertension guideline (NG136) in 2026?

In February 2026 NICE added a recommendation to offer advice on healthy living to people who have raised blood pressure but have not been diagnosed with hypertension. NICE also says it is monitoring ongoing research on how people from different ethnic groups respond to antihypertensive drugs, which may lead to a later update.

What is new in the NICE sepsis guideline (NG253)?

On 23 September 2026 NICE reviewed the evidence on procalcitonin (PCT) testing and amended recommendations 1.8.2 and 1.8.16 of NG253, its guideline on suspected sepsis in people aged 16 or over. NG253 partially updates and replaces NICE guideline NG51 from 2016.

What changed in the NICE menopause guideline (NG23) in 2026?

In April 2026 NICE amended its advice on when to seek help for vaginal bleeding while taking systemic HRT, in the section on starting HRT. NG23 was first published in November 2015 and remains the NICE guideline on menopause.

What does a NICE guideline number such as NG28 mean?

NG stands for NICE guideline, and the number identifies the guideline. Older NICE clinical guidelines used the prefix CG. When a new guideline replaces an older one, NICE says so on the guideline page, for example NG259 replaces CG146 and NG253 partially replaces NG51.

Do NICE guidelines apply across the whole UK?

NICE develops its guidelines for England. The governments of Wales, Scotland and Northern Ireland decide how NICE guidance applies there. Scotland also has its own guideline body, SIGN, and Northern Ireland's Department of Health reviews NICE guidelines for local endorsement.

Is this page an official NICE source?

No. This is an independent summary by DR. INFO and is not affiliated with or endorsed by NICE. Each entry links to the official guideline, which is the version to rely on.

The official, current versions of all NICE guidelines are on the NICE website.

All published NICE guidance

Summaries are for orientation only and were checked against the NICE website on 30 September 2026. Guidelines change, so always read the current version on the NICE website before making clinical decisions. DR. INFO is not affiliated with or endorsed by NICE.