Community Practitioners' and Health Visitors' Association

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National Institute of Clinical Excellence -Developing Clinical Guidelines – Consultation Document : CPHVA Response

  • Overall the Association would like to encourage N.I.C.E. to consider a broad approach to guideline production including prevention as well as management of disease areas where appropriate. This is in line with government policy as set out in ‘Saving Lives’ (Dept. of Health, 1999).

  • Whilst the Association does not have well developed skills in guideline production would have value the opportunity to develop these by contributing to the process where it has a stake in the guideline topic.

The general suitability of this model for developing clinical guidelines:

The model appears robust, offering sufficient opportunities for quality assurance.

  • It might be useful for the process to be piloted over the first 3 guidelines and an individual process evaluation completed by the authoring group on completion of each guideline thereafter. The process could then undergo ongoing change as necessary

  • It may be useful to state a realistic timescale as a guide for the team leading its production

For the guideline production process:

  • It is necessary to consider the broader applications of a guideline to increase its value and usability. For example, for ‘ Depressive illness in the community’, the guideline could cover the prevention of depression (such as postnatal) and its early detection as well as the psychosocial and medical management. The guideline development group should then include midwives, health visitors and community psychiatric nurses as well as general practitioners and psychiatrists.

  • It would be helpful if in any year there was guidelines produced of interest to all the professional groups so that interest in the process is maintained.

The way in which we intend to involve stakeholders:

  • When the guideline topics are advertised potential stakeholders could be invited to state their interest in becoming involved with development of the guideline.

The process for selecting guideline authoring groups

  • This could be dynamic with the Institute encouraging observers from those professional bodies with less experience of guidelines production so that may gradually take on a more active role

What arrangements you consider we should put in place for disseminating guidelines

  • There is a need to learn from the experience of the York reviews

  • As it is intended these guidelines will be implemented they must be disseminated through local management structures in Trusts. However, this process could be backed by support from the Professional bodies by way of publicity, editorials in their journals, clinical effectiveness bulletins etc.

  • It would also be helpful for those professions not involved with implementing the guideline, but involved with the patient groups targeted by the guideline, to be made aware of the guideline’s existence. For example health visitors/school nurses in relation to asthma guidelines.

  • Implementation is another issue and key to the success of the whole process