How all Scottish Intercollegiate Guidelines Network guidelines are monitored to assess their impact and whether their implementation has be…

In 2001, a survey of progress by NHSScotland in implementing Scottish Intercollegiate Guidelines Network (SIGN) guidelines was carried out by a sub-group of the Clinical Resource and Audit Group (CRAG) and a summary report was published in July 2002. A copy of the report can be found on the CRAG website at: http://www.show.scot.nhs.uk/crag/. This survey demonstrated that the implementation of SIGN guidelines is widespread throughout NHSScotland. Targeted dissemination of guidelines routinely occurs in almost all trusts, and most trusts have an explicit strategy for implementing guidelines following dissemination. As recommended in previous studies on methods of implementing evidence-based medicine, a combination of approaches (appropriate to local circumstances) has been used in the service. However, the survey also demonstrated that the implementation of individual guidelines was highly variable. A number of success factors and barriers to implementation were identified, many of which were applicable to a number of trusts. Although the implementation of SIGN guidelines will continue to be the responsibility of trusts, the introduction of unified NHS boards and Board Clinical Governance committees provides an opportunity to facilitate successful implementation, and to overcome barriers.In addition, assessment visits carried out by the Clinical Standards Board for Scotland monitor compliance with condition-specific and clinical governance ("generic") standards. These assessments will ensure that procedures are in place to implement SIGN and other relevant evidence-based guidance.