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Scotland's way to guarantee quality

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7227.78 (Published 08 January 2000) Cite this as: BMJ 2000;320:78

With Scotland's Clinical Standards Board about to produce its first standards for consultation, Bryan Christie meets its chairman, Lord Naren Patel

It's not NICE and it has no intention of emulating its bigger sibling south of the border. The Clinical Standards Board for Scotland believes it has developed its own effective framework for providing the public with assurances about the safety and quality of the country's health service.

The Scottish system is very different from the model adopted in England, where the National Institute for Clinical Excellence (NICE) will work alongside the Commission for Health Improvement (CHI) in identifying best practice and ensuring its delivery. That is largely because many of the building blocks for a system of quality assurance were already in place in Scotland, before England's institute was established.

The Scottish Intercollegiate Guidelines Network (SIGN), set up by the royal medical colleges, has been working since 1993 to produce treatment guidelines, and the Clinical Resource Audit Group (CRAG) has ensured that audit work is well advanced. The national data on clinical outcomes have produced a wealth of comparative information on performance across the country.

The missing ingredient in all of this …

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