A rough guide to implementation: the Royal College of General Practitioners (RCGP) in Scotland

Article type
Authors
Donald P, Farquharson A, Cotton P
Abstract
Introduction/Objective: To facilitate the implementation of national guidelines, developed by SIGN (the Scottish Intercollegiate Guideline Network), in primary care in Scotland. There has been concern that that the work involved to produce valid and valued guidelines would not achieve an improvement in patient care unless there was a coordinated approach to implementation.

Methods: The RCGP appointed a Guidelines Coordinator to ensure active GP representation and consultation from all stages from development to implementation. Key issues for primary care were explored at two national multidisciplinary consultative meetings.

Results: A network of key representatives in 15 Health Authorities was set up to integrate implementation within geographical areas, and a database of practitioners' special interests has been established. Roadshows were established at six venues to explore practical ideas for implementation of national guidelines in local practice. An educational video and literature supported the meetings and have been evaluated. This was a collaborative venture with the Nursing Board for Scotland, and the Scottish Council of Pharmacy.

Discussion: The network of key representatives has ensured collaboration with all major stakeholders including non-college family practitioners. The Guideline Coordinator has used structured feedback to create a plan for facilitation incorporating a range of innovative ideas for implementation in many different settings. This is an excellent example of multidisciplinary collaboration and has led to discussion both in primary care and across the interface with secondary care. This model demonstrates that a variety of educational initiatives are required to ensure the translation of national guidelines into local practice to improve patient care.