http://blogs.bmj.com/bmj/2012/07/13/pritpal-s-tamber-brave-iom-starts-defining-the-knowledge-to-practice-chasm/ Just another blogs.bmj.com weblog Sun, 10 Feb 2013 15:13:00 +0000 hourly 1 http://wordpress.org/?v=3.5.1 http://blogs.bmj.com/bmj/2012/07/13/pritpal-s-tamber-brave-iom-starts-defining-the-knowledge-to-practice-chasm/#comment-15967 Guest Sun, 15 Jul 2012 22:37:00 +0000 http://blogs.bmj.com/bmj/?p=18653#comment-15967 Local implementation of guidelines in my experience has always been championed. But the question is how local. The new NHS structure is an opportunity to agree these at a cluster wide level with with stamp of approval from the clinical senate level. This should hopefully reduce within regional variation, but also provide a fair commissioning framework for all the providers across a region to adhere to. If  patient decided to venture slightly further afield, the patient will still get an accepted level of care and also getting referred wont depend on what GP locality you are in or which referral management process your area is subject to. Also, on the ground, there are so many sources of clinical evidence all presented in a matter not easy to digest nor apply to the clinical scenario facing you. 

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