Towards better prescribing – a model for implementing clinical guidelines in primary care organisations in the NHS

Clinical guidelines aim to disseminate evidence and thus to change behaviour. This process is complex and needs a coherent approach. Aims to develop a model for implementing clinical guidelines in primary care and thus influencing prescribing by general practitioners (GPs). A total of 25 semi‐structured interviews were conducted with GPs and primary care academics. To enrich the model an ongoing literature review of guideline implementation and changing prescribing behaviour was used. A simple model was derived to guide primary care organisations and GPs in implementing guidelines for prescribing, which comprises six steps: choose the condition; choose the guideline; identify influential people; identify organisational factors; plan and adopt an implementation strategy; and monitor the resulting adherence. The model provides a framework for planning the implementation of guidelines, and recognising barriers that hinder adherence to guidelines. It may help to explain why clinical guidelines vary in their uptake.