Keep local policies aligned with national guidance.

What it is and who it's for

Local Guideline Alignment is a governance tool that automatically compares NHS Trust or ICB clinical policies against the latest national guidelines from NICE, NHS England, and other authoritative bodies. It identifies discrepancies, omissions, and outdated recommendations, providing a clear audit trail for any local deviations.

This feature is designed for Clinical Governance Teams, Patient Safety Leads, Medical Directors, and Clinical Commissioning Groups responsible for maintaining and approving local clinical protocols. It ensures that local adaptations are deliberate, justified, and recorded, rather than accidental oversights.

The system is particularly valuable during Care Quality Commission (CQC) inspections, internal audits, and clinical negligence claims, where demonstrating proactive policy management is essential. By providing a systematic approach to guideline alignment, it reduces the risk of clinical practice being based on outdated or non-evidenced local protocols.

How it works

Inputs

The system accepts local policy documents in common formats (PDF, DOCX) and connects to live feeds of national guidance. Administrators can map specific sections of a local policy to corresponding national recommendations, creating a structured relationship between the two.

Supported national sources include NICE guidelines, NHS England policy directives, Royal College recommendations, and specialist society guidance. The system maintains a comprehensive library of current and historical versions of these documents for accurate temporal comparisons.

Processing

Using natural language processing, the tool indexes the content of both local and national documents. It performs version tracking to monitor when national guidelines are updated. The system compares the mapped sections, analysing wording, clinical parameters, and recommendations for alignment.

The comparison engine uses semantic analysis to understand clinical concepts rather than just keyword matching. This allows it to detect when different terminology is used to describe the same clinical approach, reducing false positives. For quantitative recommendations (e.g., dosage, timing thresholds), it performs numerical comparisons with configurable tolerance levels.

Outputs

The primary output is a dashboard highlighting areas of alignment and divergence. For each discrepancy, the system provides an alert indicating the nature of the difference (e.g., stricter local policy, omitted recommendation, outdated reference). It generates audit artefacts showing the comparison results, timestamps of the last review, and any approved justifications for local deviations.

Outputs include visual alignment scores for quick assessment, detailed discrepancy reports with side-by-side text comparisons, and automated notifications when national guidelines change affecting mapped policies. The system can generate ready-for-audit documentation showing the governance process followed for each policy review cycle.

Example workflow

1. Policy Upload: A Trust's new antibiotic prescribing policy is uploaded to the CliniSearch platform.
2. Mapping: The governance team maps the policy's sections to relevant NICE guidelines on antimicrobial stewardship.
3. Automated Analysis: The system compares the local policy wording and recommendations against the current NICE standards.
4. Divergence Report: The tool flags that the local policy recommends a 7-day course for a specific infection where NICE now recommends 5 days, and highlights an outdated reference to a retired guideline.
5. Review and Action: The governance team reviews the flags, approves the justified 7-day course based on local resistance patterns, and updates the outdated reference.
6. Audit Trail: The system records the review decision, including the clinical rationale for maintaining the divergence, ready for any future audit.

This workflow typically reduces policy review time from weeks to days by automating the comparison process and focusing human effort on clinical decision-making rather than manual document comparison. The system maintains a complete history of all policy versions and comparison results, allowing governance teams to track improvement over time.

Governance and safety

Provenance Tracking

All national guidelines are sourced from official publishers with version and publication dates recorded. Local policies are version-controlled with upload timestamps and editor identification.

The system maintains cryptographic hashes of all documents to ensure integrity and prevent undetected modifications. Each comparison operation records the exact versions of both local and national documents used, creating an immutable record for audit purposes.

Update Handling

When national guidelines are updated, the system automatically re-scans all mapped local policies and generates new divergence reports for review, ensuring prompt awareness of changes.

Update alerts are prioritised based on clinical impact, with critical safety-related changes flagged immediately. The system provides context about what has changed in the new guideline version, helping reviewers understand the significance of the update.

Wording Controls

The comparison algorithm is calibrated to distinguish between clinically significant wording differences and minor paraphrasing, reducing false positives while catching substantive changes.

Administrators can configure sensitivity settings for different types of content, with stricter matching for safety-critical recommendations and more lenient matching for descriptive text. The system learns from user feedback on flagged discrepancies to improve accuracy over time.

Audit Trail

Every comparison, flag, review, and approval action is logged with timestamps and user identifiers. This creates a comprehensive audit trail demonstrating due diligence in policy maintenance.

The audit trail includes before-and-after comparisons showing how policies have evolved in response to national guideline changes. This documentation is exportable in standard formats suitable for regulatory submissions and internal governance reporting.

Frequently asked questions

Implementation

How long does implementation take? Most organisations can begin mapping policies within days. The initial setup involves connecting to national guideline feeds and training staff on the mapping process.

What technical integration is required? The tool works as a standalone web application but can integrate with document management systems via API for automated policy uploads.

What training and support is provided? We provide comprehensive training for governance teams on policy mapping and interpretation of results. Ongoing support includes regular system updates and clinical safety oversight.

Data handling

Where is our policy data stored? All data is stored in UK-based data centres compliant with NHS Data Security and Protection Toolkit requirements. Local policies are encrypted at rest and in transit.

Who has access to our local policy comparisons? Access is controlled by your organisation's administrators. CliniSearch staff do not have access to your policy content without explicit permission.

How is sensitive clinical information protected? The system operates on a need-to-know basis, with role-based access controls ensuring that only authorised personnel can view specific policy comparisons. All access is logged and monitored.

Limitations

Can the system interpret clinical justification for deviations? The tool flags discrepancies but cannot assess clinical rationale. The governance team must review and approve deviations based on local context.

How does it handle ambiguous or complex guideline language? The system highlights potential discrepancies for human review but may flag some clinically acceptable variations that require expert interpretation.

What about guidelines that require local interpretation? The system recognises that some national guidelines explicitly allow for local adaptation. These areas are flagged as "expected variation" rather than discrepancy, with prompts to document the local implementation approach.

Core capabilities