RCOT 2018 Blog 9 Sess. 29 Evidence Based Practice and National Guideline Development. Do the National Institute of Care and Excellence (NICE) guidelines provide Therapists with meaningful evidence for practice?

This thought provoking seminar was hosted by Dee Christie who is a retired occupational therapist and a current NICE Fellow. It explored the presenter’s experiences of chairing the NICE guideline committee on Intermediate Care and the challenges of incorporating guidelines into practice. I was motivated to attend in order to develop my understanding of how NICE guidelines are produced, and have the opportunity to discuss strategies for incorporating evidence – based paradigms into practice.

As an introduction the steps involved in producing NICE Guidelines were discussed, this process usually takes about two years and includes involvement from working groups who are made up of health and social care professionals, patients, carers, members of the public and experts in the field.

As well as discussions about the development of the guidelines this seminar identified the ten commandments of EBP (as defined by Bannigan and Burleson, 2007) and also covered the challenges of embedding guidelines into practice.

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Examples of NHS Trusts that have well established governance structures that ensure guidelines are incorporated into frontline clinical care were discussed and practical strategies of how to embed evidence into practice personally were included.

These included:

  • Find yourself guidelines that support your practice and discuss it with your team
  • Take responsibility for your personal learning, be active in seeking out actively appropriate evidence to support your practice
  • Make a commitment to yourself to do something simple for CPD every month, one example from the presenter was to commit to reading one article from the BJOT a month, small actions like this can then become habitual over time.

There was a lively discussion relating to the benefits and disadvantages of implementing the guidelines into clinical practice, the sheer number of guidelines available was discussed and the lack of time available to implement recommendations. Some therapists have suggested that guidelines can lack a client centred focus. However in contrast the increasing opportunities for AHP’s to get involved in the development of the guidelines was emphasised, and the robustness of some of the recommendations was identified as supportive for occupational therapists working in MDT’s.

In response to a comment from the floor that suggested there are some topics that currently aren’t properly covered by NICE guidelines the discussion moved onto how occupational therapists need to focus on creating more evidence from our practice to build the evidence base, with the presenter concluding that if our profession isn’t defined by evidence then we wont move forward.

Since attending the seminar I have had time to reflect on the funding opportunities that are currently available for occupational therapy clinicians who are interested in developing a research career (through organisations such as the NIHR and the Elizabeth Casson Trust ) and I would encourage anyone interested in doing this to visit their websites for more info as to how to get started.

I left the seminar with a better understanding of how NICE Guidelines are created, and developed, and with strategies to take back to my clinical team to enable us to embed them deeper into our practice.

Written by Elspeth Clark    @Els_OT

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