As we move into 2001, the Scottish Intercollegiate Guidelines Network (SIGN)* is growing ever closer to producing its 50th clinical guideline.
While 'SIGN 50' will be a unique publication, being a virtual guide to guideline development, we find ourselves embracing another new challenge developing 'patient-friendly' guidelines in a language and format that patients can understand and use in order to enable them to work with clinicians to become equal partners in their own healthcare.
We in Scotland are still coming to terms with the recent announcement of the unprecedented investment of £14m, by the Scottish Executive, in developing patient information.
For those of us involved in translating often complex clinical information into a more user-friendly format, this announcement, in the Scottish Health Plan,1 marks a tremendous breakthrough in developing quality-assured patient information and goes far beyond mere political rhetoric or political correctness.
The £14m will cover a number of initiatives, such as establishing touch-screen patient information points in community areas and developing electronic smart cards containing patient records in order to facilitate the patient's journey through care. But perhaps the most exciting development for everyone involved in clinical effectiveness is that all clinical guidelines are to be developed in patient-friendly formats.
When I recently took up post as Primary Care Adviser to SIGN I was given a wide remit: to identify ways of involving all members of the primary care team in the guideline development process; to work with all those in primary care to ensure that guideline topics selected for development are of relevance to them in their daily clinical work (including helping to work up such proposals); and to explore ways in which we can work together to implement the recommendations of the guidelines.
Also, and equally important, I was given responsibility for developing patient information based upon SIGN guidelines.
As practising clinicians, we have all been faced with trying to explain detailed clinical information to a patient in a manner that they can understand. We will also have seen the patient who, quite rightly, wants to understand more about his/her clinical condition, and comes to the consultation with information that he/she has obtained (from the internet or another source). At best this information does not relate directly to the patient's condition, and at worst it only serves to confuse the patient and perhaps cause more anxiety.
Given the wealth of evidence that is considered and evaluated during the guideline development process, what could be better than the further utilisation and development of this evidence into usable quality-assured information in different styles to meet the needs of clinicians, patients and non-clinicians alike.
SIGN already involves patients and voluntary organisations in the development of its guidelines, and the development of quality-assured patient information based on these guidelines is a task we look forward to.
The Scottish Executive's recent commitment to developing not only patient information generally, but also patient information relating specifically to clinical effectiveness and clinical guidelines, marks a significant development in efforts to involve patients in their own healthcare, and gives further weight to the importance of clinical guidelines in promoting best practice.
*SIGN was established in 1993 by the medical Royal Colleges (covering all the medical specialties, dentistry, nursing, professions allied to medicine, and pharmacy) to improve the effectiveness of clinical care for patients in Scotland by developing, publishing and disseminating evidence-based guidelines that identify and promote good clinical practice and which, if implemented locally, will help to address variations in clinical practice throughout Scotland. SIGN is a professionally led, multidisciplinary organisation with the costs of the SIGN Secretariat being funded by the Clinical Resource and Audit Group (CRAG) of the Scottish Executive.
- The Scottish Executive. Our National Health: A plan for action, a plan for change. December 2000.