Abstract
The National Institute for Clinical Excellence (NICE) was set up in the UK ‘to provide patients, health professionals and the public with authoritative, robust and reliable guidance on current best practice. In March 2000, NICE provided national guidelines for the selection of prostheses for total hip replacement.
Aim: To determine how useful the NICE guidelines for selection of prostheses for primary total hip replacement were to patients who were undergoing total hip replacement (THR) and the health professionals who were looking after them.
Method: We surveyed 100 patients, 50 Orthopaedic Surgeons, 40 Orthopaedic nurses and posted a questionnaire to GPs, to which 79 replied (56% response rate).
Results: 19% of patients had heard of NICE, but only 2 % were aware of the existence of NICE guidelines on THR and 1% found them useful. Almost all orthopaedic surgeons had heard of NICE and their guidelines for THR, with 74% knowing what the guidelines actually stated but only 14% finding them useful. 78% of surgeons believed that their preferred hip replacement conformed to NICE guidelines, 2% knew that they did not conform and 20% did not know. 27% of general practitioners knew of the guidelines, but only 5% knew what they actually stated and 1% found them useful in their practise. Most nursing staff working in orthopaedic areas had heard of NICE (83%). 43% knew of the NICE guidelines but only 13% knew the actual guidelines and 8% found them useful.
Conclusion: NICE has failed to communicate its guidelines to both patients and the public. Few of the health-care professionals found the guidelines of use in their day to day practice. In this instance, NICE has failed to fulfil its mission statement of providing patients and healthcare professionals with reliable guidance on hip replacement prostheses.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
