Conflicting perspectives during guidelines development are an important source of implementation failure

Dados Bibliográficos

ID21467671
AutoresJonathan Michaels (0000-0002-3422-7102, University of Sheffield, autor correspondente), Ravi Maheswaran (0000-0002-3899-4421, University of Sheffield)
Ano2023
Volume131
Páginas104801
Data de publicação2023-05-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoHealth Policy (JOURNAL)
Identificadores do periódicoISSN: 0168-8510 • E-ISSN: 1872-6054
EditoraElsevier BV (PUBLISHER)
DOI10.1016/j.healthpol.2023.104801
PMID36990043
OpenAlexW4360840718
IdiomaEN
Referências citadas40

In recent years many countries have created national bodies that provide evidence-based guidance and policy relating to the commissioning and provision of healthcare services. However, such guidance often fails to be consistently implemented. The differing perspectives from which guidance is developed is suggested as a significant contributor to these failures. A societal perspective is, necessarily, taken by policy makers, while patients and their healthcare professionals are primarily concerned with an individual perspective. This is particularly likely to impair implementation where national policy objectives, such as cost effectiveness, equity, or the promotion of innovation, are embodied in the guidance, while patients and healthcare professionals may consider it appropriate to over-ride these, based upon individual circumstances and preferences. This paper examines these conflicts with reference to guidance issued by the National Institute of Health and Care Excellence in England. Conflicts are identified between the objectives, values, and preferences of those who develop and those who implement such guidance, with consequent difficulties in providing helpful personalised recommendations. The implications of this for the development and implementation of guidance are discussed and recommendations are made regarding the ways in which such guidance is framed and disseminated

Excellence · Health care · Political science · Project commissioning · Public relations · Publishing · Clinical practice guidelines implementation · Computer Science · Healthcare cost, quality, practices · Medicine · Primary Care and Health Outcomes