- Putting the D into “R&D”

The Society has a long tradition of promoting and carrying out research. Now the BGS is developing its commitment to clinical effectiveness through the CPEG

The Clinical Practice Evaluation Group (CPEG) is a sub-committee of the Academic and Research Standing Committee of the Society. The role of CPEG is to promote the conversion of evidence based research knowledge into best practice – promoting the “development” part of “research and development”.

Many other specialist medical societies have well established traditions for developing guidelines and carrying out audit that have informed practice nation wide. The CPEG will endeavour to move the BGS in a similar direction.

Recent years have seen an increasing emphasis on the need to implement change and service development and to evaluate services in an objective way. National bodies such as the National Institute of Clinical Excellence (NICE), the Commission for Health Improvement (CHI), the National Health Service Information Authority (NHSIA), the Modernisation Agency and the Audit Commission are examples of these changes.

Equally new methods have developed for the acquisition, aggregation and interpretation of research findings. Information scientists and systematic reviewers have become highly sought after professionals. There are now rigorous methods for the development of guidelines, the carrying out of audit and the implementation of change.

Current Activity
The CPEG is developing on various fronts, namely:
1. Contributing to national bodies
The CPEG receives requests from NICE for representation on guideline development groups and for stakeholder input into guidelines under development. Many members of the Society have already contributed. This is invaluable work, as the guidelines will inevitably form the basis for a national approach to the management of conditions. It is essential that the needs and requirements of older people are recognised and incorporated. Examples of NICE guidelines underway include:

• Cardiac Failure
• Chronic Obstructive Pulmonary Disease
• Pressure Sores
• Epilepsy

The CPEG contributes suggestions to national bodies for Health Technology Appraisal and for further guidelines.

2. Carrying out Society based audit
The CPEG has established a database of departments interested in contributing to multicentre BGS audit. The first exercise is currently underway with departments contributing to an audit of appropriate prescribing of bisphosphonates to prevent steroid induced osteoporosis. It is hoped to present the results of the audit at the Autumn Meeting of the BGS in the “PRACTICE” section.

3. Contributing to the Royal College of Physicians (London) Clinical Effectiveness Forum
The Royal College of Physicians (London) has an established forum of specialist societies which meets to promote clinical effectiveness. To date the Forum has established a database of clinical guidelines developed by member societies and these are being “kite marked” on the basis of the methodological soundness. Details of guidelines on the database on the RCP (London) website: www.rcplondon.ac.uk

The Forum is currently seeking information on multicentre audits carried out by member societies. These will also be entered onto a database with the view that departments interested in similar audits can use the same methodology and compare results with other departments around the country.

4. CPEG sections within the BGS Spring and Autumn Meetings
CPEG has initiated a new section within the Spring and Autumn Meetings of the BGS to highlight and promote best practice.

CPEG at Aberdeen
The inaugural session of the Clinical Effectiveness section of the poster presentations was held at the Aberdeen meeting. 10 posters had been accepted covering aspects of practice development including:

• audit pressure sores, resuscitation hospital infection
• guideline production bowel care
• best practice falls service
• care pathways stroke

These poster presentations had been adjudicated by members of the CPEG committee and had been judged to be based on sound scientific method. Dr John Pounsford and Dr Martin Connelly – both recognised nationally for their work in clinical effectiveness – reviewed the posters and discussed issues of clinical relevance and scientific rigour. While these presentations will not be published in Age & Ageing, they attracted great interest and stimulated much discussion. It is hoped that similar sessions at future meetings will provide a useful forum for members of the Society to discuss methods of service improvement.

Members are invited to submit abstracts for the BGS Autumn Meeting using the abstract submission guidelines in the usual way. The deadline for submission is 1 June. In addition to the areas of service development above, other aspects might include: benchmarking of services, innovations in service development. The Committee would emphasise that submissions must be directed towards the “PRACTICE” section for abstracts. The submissions are adjudicated separately from those submitted to the research component of the BGS meeting. In view of time constraints and the need to give an unbiased review of all abstracts submitted, abstracts cannot be referred from the research sections to the clinical effectiveness “PRACTICE” section once the deadline has passed.

Conclusion
The work of CPEG has got off to a good start. I am extremely grateful to the members of the CPEG Committee for their interest and enthusiasm. I hope members of the Society will find this new development of interest and will seek to support the initiative through encouraging their departments to contribute to the activities of CPEG.

JM Potter
CPEG Chairman
jonathan.potter@ekht.nhs.uk