Intended for healthcare professionals


One day or day one? Uptake of new prescribing guidance in general practice

BMJ 2019; 367 doi: (Published 02 October 2019) Cite this as: BMJ 2019;367:l5652

Linked research

Variation in NHS clinicians' response to new guidance

  1. Emma Wallace, senior lecturer in general practice1
  1. 1Department of General Practice, Royal College of Surgeons in Ireland, 123 Stephen’s Green, Dublin 2, Ireland
  1. Correspondence to: E Wallace emmawallace{at}

The pace of change is still highly variable, with implications for patient care and health expenditure

Internationally, the drive to improve healthcare quality and cost effectiveness is underpinned by evidence based medicine. However, the pace of change in healthcare is rapid and the implementation of new evidence into clinical practice is suboptimal.1 General practitioners offer comprehensive care at the first point of access for undifferentiated problems. Their role has changed substantially over time, with increasing demand for services coupled with the need to adopt medical and technological innovations swiftly.

In a linked article in The BMJ, Walker and colleagues (doi:10.1136/bmj.l5205) provide a large analysis of general practitioner uptake of prescribing recommendations.2 In healthcare, diffusion of innovation describes the process whereby warranted change is adopted into clinical practice. Typically, the rate of change varies over time with a small number of early adopters, a rapid middle adoption phase as momentum gathers, and a slow third phase as the innovation becomes embedded over time.3

The current study used OpenPrescribing …

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