CLINICAL GUIDELINE	GC10001-1
Trust Guidelines Template

For use in (clinical areas):	All clinical areas
For use by (staff groups):	All clinicians
For use for (patients):	For use for
Document owner:	Document owner
Status:	Draft

Please click the ‘Document Management’ button on the menu bar to fill in the above fields.

All the italicized text in this template should be replaced with pain text or deleted.

Purpose of the Guideline

This section should briefly state why the guideline was written (for example, implementation of a national guideline, improved costs, clinical effectiveness,) and exactly what it is intended to achieve.

Contents

Include a contents list of the main sections if the document is long, e.g. more than 3 pages.

Main body of document

The main body of the document should go here. There is no set format. Longer documents should be broken up into sections and sub-sections for ease of reading.

Recommendations and procedures

If the instructions are long, it may be good idea to start with a quick reference page or pages and put detail further on. Use flow charts or other diagrams followed by lists of instructions to explain complex procedures. The easiest way of producing flow charts is to draw them in Powerpoint, save this as a GIF file and insert the file into Word as a picture.

Ensure that any potential problem areas in procedures are highlighted. The term CAUTION should be used where a procedural step may fail for some reason. The term WARNING should be used where there is potentially a serious risk to patients or risk of damage to equipment if the procedure is not carried out as indicated. NOTES should not be used for essential information.

Rationale for main recommendations

Include in this section any additional information about the rationale for the main recommendations and the reasons why particular decisions were made.

Note: most guidelines will be based on established clinical evidence and practices, either nationally or locally defined. If the guideline or protocol modifies or augments these practices, then these changes should be highlighted in this section.

References:

A list of references (if applicable) should be placed at the end of the main body of the document. Additional background information and resources can be referred to in a separate ‘Bibliography’ section.

Development of the guideline

Changes compared to previous document

Indicate any changes made in this guideline compared with any guideline(s) that it replaces or supercedes. This applies to a guideline that has been re-issued with a different issue number or a guideline that supercedes a previous document with a different reference number.

Statement of clinical evidence

Indicate whether or not the guideline is based on local evidence or recognized published evidence, e.g. a national guideline. The source of this evidence should be given where possible. Indicate whether a systematic review of the literature was carried out and explain briefly what results were obtained. If the evidence is considered to incomplete or inconsistent, this should also be indicated here.

List any additional sources of evidence or background information (such as web sites) not included in the list of references above.

Contributors and peer review

Indicate who (i.e. individuals, departments and /or groups) contributed to the development of the guideline and to whom the guideline was circulated for review. Indicate any major issues that arose and how they were resolved.

Note: the departments and/or groups that have reviewed and approved the guideline should be listed in the document information at the end of the document. Use this section to indicate any further information, particularly any issues that arose during decision making.

Distribution list/dissemination method

List the specific persons or groups that are to receive paper copies of the guideline, e.g. consultants, wards, primary care trusts, local community care trusts, heath care workers, social services. State who is to be responsible for distribution and how awareness of the guideline will be promoted. Note: approved guidelines will also be made available throughout the Trust in the Pink Book.

Document configuration information

Fill in the fields in the following table as far as is known. Some of these fields may be assigned when the document has been approved for distribution. Note that the Author(s) field indicates the person(s) who wrote the guideline, whereas the Document Owner field (on the front page of the guideline) is usually assigned to a department, a specialist area or a recognized Trust committee or group.

Author(s):
Other contributors:
Approved by:
Issue no:
File name:
Supercedes:
Additional Information:

West Suffolk Hospitals NHS Trust	GC10001-1

Trust Guidelines Template

Source: Document owner	Issue date:	Page 2 of 2
Status: Draft	Valid until:

Source: Document owner	Issue date:	Page 1 of 2
Status: Draft	Valid until:

Trust Guidelines Template

Template version 2, July 2002
(general template)

Hunter

2002-07-17

Clinical Guideline

West Suffolk Hospitals NHS Trust