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Conflicting perspectives during guidelines development are an important source of implementation failure.
- Source :
-
Health policy (Amsterdam, Netherlands) [Health Policy] 2023 May; Vol. 131, pp. 104801. Date of Electronic Publication: 2023 Mar 24. - Publication Year :
- 2023
-
Abstract
- 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.<br />Competing Interests: Declaration of Competing Interest Both authors declare funding from the NIHR Programme Development Grants Programme (NIHR202042). JM has previously chaired a National Institute of Health and Care Excellence (NICE) Guideline Development Group and been vice chair of the NICE Appraisals Committee.<br /> (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
England
Administrative Personnel
Patients
Health Personnel
Policy
Subjects
Details
- Language :
- English
- ISSN :
- 1872-6054
- Volume :
- 131
- Database :
- MEDLINE
- Journal :
- Health policy (Amsterdam, Netherlands)
- Publication Type :
- Academic Journal
- Accession number :
- 36990043
- Full Text :
- https://doi.org/10.1016/j.healthpol.2023.104801