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Information In Practice

Guidelines in general practice: the new Tower of Babel?

BMJ 1998; 317 doi: (Published 26 September 1998) Cite this as: BMJ 1998;317:862
  1. Arthur Hibble, acting director general practice postgraduate education (,
  2. David Kanka, consultant in public health medicineb,
  3. David Pencheon, consultant in public health medicinec,
  4. Fiona Pooles, research nursea
  1. a General Practice Office, NHS Executive Anglia and Oxford, Fulbourn Hospital, Cambridge CB1 5RB
  2. bCambridge and Huntingdon Health Authority, Fulbourn Hospital, Cambridge CB1 5EF
  3. cInstitute of Public Health, University Forvie Site, Cambridge CB2 2SR
  1. Correspondence to: Dr Hibble

    Editorial by Muir Gray

    There is anecdotal evidence that general practitioners are being flooded with guidelines. We set out to quantify this by conducting a survey of all guidelines retained in general practices in the Cambridge and Huntingdon Health Authority.

    Methods and results

    FP visited 22 urban and rural general practices, a sample of the 65 practices in the authority, and asked them to produce copies of all guidelines retained for use. Guidelines were defined as any written material used by a doctor or nurse in primary care to assist decision making in relation to health care,1 excluding medical textbooks and electronic databases.

    We found 855 different guidelines—a pile 68 cm high weighing 28 kg (see fig). There were 243 single page and 195 two page guidelines. There …

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