OBJECTIVES: Between January 2007 and September 2014 NICE report that they have made 65 health technology assessment decisions categorised by them as a “recommended in line with clinical practice” (RiLwCP).  This categorisation is not explained and implications for patient access are not clear.    Using a previously developed method, we calculate the degree of recommended access for these decisions.  In order to facilitate understanding we also develop a taxonomy for the factors underlying these decisions.  METHODS: In a previously published paper we developed a measure, M, to summarise access associated with NICE technology optimised appraisal decisions. This was defined as M=(p/P)X100, where M is a measure of the level of patient access (0 equals no access, 100 full access), P is the set of patients considered in the guidance as potential candidates for treatment (given the scope of appraisal and license), and p is the number of patients for whom NICE did recommend.   We applied measure M to the 65 RiLwCP decisions made between January 2007 and September 2014.  Then assessing the guidance documents published for these decisions we identified six themes driving specific recommendations: reference to a previous NICE TA, existence of a relevant clinical guideline, the technology fits within an established pathway of care, clinical opinion, clinical/cost-effectiveness matching, non-pharmaceutical.  RESULTS: For 65 decisions between January 2007 and September 2014 M was 66.    Among the factors underlying RiLwCP decisions the most common were instances where the committee matched cost and clnical effectiveness evidence, doing so in 37% of cases.    CONCLUSIONS: The results for this period suggest that many RiLwCP decisions have the same characteristics as those classified as “optimised” by NICE; notably that use is restricted to a subgroup of patients relative to license and this is done for clinical and/or cost effectiveness considerations.