Primary care trusts could be 'fudging' the information they supply to the Healthcare Commission on the implementation and uptake of clinical guidance.

Giving evidence to the Commons health select committee's investigation into the role of the National Institute for Health and Clinical Excellence, Association of Directors of Public Health president Dr Tim Crayford admitted there was an 'information gap' in the data PCTs have available on whether locally contracted clinicians and GPs are adhering to the guidance.

'A lot of NICE guidance is relatively complex and the NHS simply does not have the measurement tools to ascertain whether or not NICE guidance or guidelines are being implemented to the nth degree,' Dr Crayford told MPs.

'The honest truth is that we probably don't know to a very precise measure to what extent NICE guidance is being implemented,' he added.

Evidence submitted to the committee by the ADPH about PCTs' self-declarations to the Healthcare Commission says: 'It is assumed most PCT boards will have signed their self-declaration of compliance [on implementation of NICE guidance] even though the evidence from a wide range of patient groups and others is slow and incomplete.

'This may be because the wording of the [Healthcare Commission] standard appears to allow not much more than noting of guidance. The failure to implement guidelines needs to be addressed.'

Speaking to HSJ, Dr Crayford last week called for an 'agreed mechanism by which the NICE guidance is implemented and audited'.

Also giving evidence to the committee, the chair of the NHS Confederation PCT Network Dr Lise Llewellyn said the primary role of PCTs was to make money available to fund guidance.

'When we have a NICE recommendation it is the role of the PCTs to make sure the resources are available for that technical appraisal to be implemented.'

Asked by independent MP and committee member Dr Richard Taylor whether PCTs 'fudge to the Healthcare Commission on the true position of the implementation of NICE guidance', Dr Llewellyn admitted there was often a delay between the guidance being published and funded and clinicians using it.

'At the end of the day it is a conversation between the consultant, doctor and that individual patient.

'I would not agree that PCTs are actually fudging it, but I would agree that sometimes it is difficult to give clear information,' she said.

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