References1. Grupo de trabajo sobre GPC. Elaboración de guías de práctica clínica en el Sistema Nacional de Salud. Manual metodológico. Madrid: Plan Nacional para el SNS del MSC. Instituto Aragonés de Ciencias de la Salud - I+CS; 2007. 143 pp.(Guías de Práctica Clínica en el SNS: I+CS; nº 2006/1).

G-I-N Conference Berlin 2012

Six Years of the Spanish NHS Clinical Guideline Programme

Susana García Rodríguezsgarcia.iacs@aragon.es

Flavia Salcedo Fernándezfsalcedo.iacs@aragon.es

Juan Manuel García-Lechuzjmgarcialechuz.iacs@aragon.es

Background

GuíaSalud-Aragon Institute of

Health Sciences

www.guiasalud.es

To promote the development of evidence based CPG (EB-CPG) in the Spanish NHS and therefore to assist practitioners and patients in the decision making process.

The Spanish Quality Plan for the National Health Service (NHS) promotes the development and use of Clinical Practice Guidelines (CPG) linked to national health strategies, through a national programme based on an agreement between the Spanish Ministry of Health and the different Health Technology Assessment Units (HTAU).

Define scope and purposeDefine scope and purpose

Creating the guideline development groupCreating the guideline development group

Editing the CPGEditing the CPG

Defining clinical questions as per PICODefining clinical questions as per PICO

Evidence search, evaluation and synthesisEvidence search, evaluation and synthesis

Forming CPG recommendations Forming CPG recommendations

External reviewExternal review

CPG evaluation, review and updatingCPG evaluation, review and updating

CPG dissemination and implementationCPG dissemination and implementation

HTAUSteps in the

development of a CPGDevelopment of CPG in

the NHS. Methodological Handbook

Fo

rma

ts

46.111 47.051 52.271

75.928

97.652

119.059125.297

183.403

0

20.000

40.000

60.000

80.000

100.000

120.000

140.000

160.000

180.000

200.000

GPC TCA (30-abr-09)

GPC DepresiónMayor Inf (04-

feb-10)

GPC Prev. Ictus(27-may-09)

GPC Trat.Cáncer Próstata

(27-nov-08)

GPC Ansiedad(27-nov-08)

GPC DepresiónMayor (09-oct-

08)

GPC DiabetesTipo 2 (27-nov-

08)

GPC CuidadosPaliativos (27-

nov-08)

8 most downloaded CPG in the Spanish CPG NHS Programme (oct. 08 - abr. 12)

The Spanish NHS CPG development Programme is organised at two levels: a coordination level and a development level.

• A common methodology has been agreed through several methodological handbooks related to development, updating, implementation and how to involve patients in the CPG development. The “Development of CPG in the NHS Handbook” [1] is the starting point for all the process..

Methods

ResultsFrom the beginning of the Programme in 2006, with the first guidelines being published in 2008, there have been 36 CPG developed covering different topics. 25 are already published and 11 are still in development. Up to now there have been 444 people involved in the different GDG, including patients, health professionals and other stakeholders. 100 scientific societies, 34 patient associations and 25 other professional associations have also participated. Each CPG presents different versions: complete, summarised, information for patients and quick reference guidelines. The different versions are addressed to different users. CPG are presented as well in different formats: PDF, HTML, through mobile applications, PDA, e-books and paper. The eight most downloaded CPG since their publication are: Palliative Care, Type II Diabetes, Major Depression, Anxiety, Prostate Cancer, Stroke Prevention, Childhood Major Depression and Eating Disorders.

e-book PaperPDAMobile AppHTMLPDF

The Spanish NHS CPG Programme has had a an important impact in the development of CPG at national level allowing not only the development of a greater number of quality EB-CPG but also the participation of different health professionals, scientific societies and patients.

The existence of the Spanish NHS CPG Programme facilitates the development of Quality EB-CPG and enhances patient-centred decision-making process by promoting patient involvement.

CPG

GDG

Expert collaboratorsExternal reviewers

GuiaSalud Secretariat

CPG responsible

Coo

rdin

atio

nle

vel

Dev

elop

men

tlev

el

The development level is integrated by all the Guideline development groups (GDG) formed by healthcare and non healthcare professionals, the expert collaborators and the external reviewers.

The coordination level is represented by GuiaSalud secretariat and the different HTAU distributed across the country participating in the Programme, each of which have a member responsible for the coordination of the CPG being developed.

4Others

36TOTAL

3Factors influencing health status

1Conditions originating in the perinatalperiod

1Infectious diseases

4Respiratory system diseases

2Circulatory system diseases

1Genital and urinary tract diseases

6Endocrine diseases

1Neoplasia

13Mental Health

NumberCPG by disease classification

Ver

sion

s

Quick Guidelines

Information for patientsSummarised version

Complete version

Objectives

Discussion Implications