Waddell G, McIntosh A, Hutchinson A, Feder G, Lewis M, (1999) Low Back Pain Evidence Review London: Royal College of General Practitioners
There is now a considerable weight of evidence, linked with international experience, to show that clinical guidelines are only likely to influence practice if these guidelines form part of an implementation programme. In the Royal College of General Practitioners there is a recognition that local activity on guideline development is a key mechanism for gaining the ownership necessary to make changes in clinical practice. The purpose of national guidelines is therefore two-fold. First, to use national resources to bring the evidence together and to draw on a wide network to construct appropriate recommendations. As such, national guidelines are an efficient means of providing evaluated evidence for the professions. Second, to provide easily accessible evidence-based recommendations which may be all that is required for a local implementation programme to get under way. The brief guidelines, made extensively available to the professions involved with back pain care, are overleaf. Alternatively, the more extensive evaluation of the evidence and the supplementary recommendations to be found in the Review can provide the basis for local guidelines. This should lessen the effort required to develop local versions.