Q&A


Above: Dr Sara Twaddle (left) with Programme Director Dr Roberta James on receiving an eHealth award for the SIGN app. Left: Dr Keith Brown


D


R KEITH BROWN became the Royal College of Psychiatrists’ representative on the SIGN Council


in 2001 and was appointed Chair in 2007. Dr Sara Twaddle is a health services researcher and economist by background and had worked in the NHS in a variety of roles since 1988. In 2000 she joined a SIGN guideline development group as an economist and subsequently became the network’s part-time economics adviser. In 2003 she was appointed Director.


What do you see as the prime remit of SIGN? KB: SIGN’s remit remains the same as it was back in 1993, to produce high-quality, multi-disciplinary, evidence-based recommendations for NHS Scotland.


Is it the Scottish equivalent of NICE? KB:We have the same remit as the guideline development arm of NICE, but other NICE responsibilities are picked up by Healthcare Improvement Scotland (HIS), of which SIGN is a part.


How do you decide on topics for guidelines? ST: Tis depends on whether we already have a guideline covering the topic, or whether it is a totally new topic. For our extant guidelines, we look at the requirement for review at three years post


10


Translating evidence


publication. We look at the new evidence published since the last guideline and assess the degree to which it would alter the recommendations. We then consult on the review reports with clinical experts in the field to ensure that we have correctly interpreted the new evidence. Anyone can make a proposal to SIGN for


a new guideline topic (by downloading a form from www.sign.ac.uk ). Tese are then assessed within SIGN to ensure that they are suitable for a clinical guideline. We do this by considering whether the topic involves more than one discipline and whether it is actually a clinical topic. Once this is established we work with the proposer to develop a more detailed


into practice


For nearly 20 years the Scottish Intercollegiate Guidelines Network or SIGN has been producing evidence-based clinical practice guidelines for the NHS in Scotland. Here Summons speaks to SIGN Chair Dr Keith Brown and Director Dr Sara Twaddle


proposal, including looking at the size of the evidence base and evidence of variation in practice. Tese proposals are then reviewed by SIGN Council, which is made up of the representatives of all the Royal Colleges, professional organisations and lay members. If SIGN Council supports the proposal we submit these to the process within HIS which allocates budgets for pieces of work.


What goes into guideline development? ST: Essentially, the main elements are a multi-disciplinary guideline development group including patients and carers, a review of published literature, recommendations for clinical practice


SUMMONS


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