Keep local policies aligned with national guidance.

What is Local Guideline Alignment?

CliniSearch's Local Guideline Alignment module is a governance tool that systematically compares an NHS Trust's or healthcare organisation's internal clinical policies against current national guidelines from bodies like NICE, SIGN, and the Royal Colleges. It automates the detection of discrepancies, omissions, and outdated recommendations, providing a clear, auditable record of alignment status. This ensures that local practice remains evidence-based and compliant with national standards.

This feature is designed for Clinical Governance teams, Medical Directors, and clinical policy authors within NHS Trusts, ICBs, and other healthcare providers responsible for maintaining and approving local clinical guidelines. It is also invaluable for clinical audit departments and risk management teams seeking to demonstrate compliance and manage clinical risk effectively.

The tool supports organisations in meeting their obligations under the NHS Patient Safety Strategy and the Duty of Candour by providing transparent evidence of how local policies align with best practice. By systematically tracking alignment, healthcare providers can proactively address potential clinical risks before they lead to patient safety incidents or regulatory non-compliance.

How It Works

The system operates through a structured process of input, processing, and output to deliver actionable insights.

Inputs

The primary inputs are the organisation's local clinical guidelines, protocols, and policies, typically uploaded in PDF, Word, or via a direct integration with document management systems. These are matched against CliniSearch's continuously updated database of national guidelines, which includes recommendations from NICE, JCVI, UKHSA, and other authoritative national bodies.

The system accepts documents in multiple formats and can handle complex policy structures with appendices and referenced documents. For organisations with established document management systems, API integrations allow for automated synchronisation, ensuring the comparison always uses the most recent version of each policy.

Processing

Using natural language processing and specialised clinical terminology indexing, the system maps local policy statements to their corresponding national recommendations. It performs version tracking to identify if a local policy is based on a superseded national guideline. The processing engine flags areas of direct alignment, partial alignment (e.g., different thresholds or timeframes), and clear divergence. It also identifies topics covered by national guidance that are missing entirely from local policies.

The processing engine uses a sophisticated clinical ontology to understand context and meaning beyond simple keyword matching. This allows it to recognise equivalent clinical concepts even when different terminology is used, and to distinguish between substantive clinical recommendations and administrative or procedural content that may not require national alignment.

Outputs

The system generates clear outputs for users. This includes direct answers to queries about alignment status for a specific clinical topic, automated alerts when a national guideline update creates a new divergence with a local policy, and downloadable audit artefacts such as alignment reports and timestamps of the last review. These outputs provide the evidence base for policy review cycles and external audits.

Outputs are presented through an intuitive dashboard interface that allows filtering by clinical specialty, alignment status, and review date. Reports can be exported in multiple formats including PDF for formal documentation and Excel for further analysis. The system also supports scheduled reporting, automatically generating alignment summaries for governance committees at defined intervals.

Example Workflow

The following steps illustrate a typical workflow for a governance manager using the Local Guideline Alignment tool to review a policy on the management of community-acquired pneumonia.

1. Access the Module: The user navigates to the Local Guideline Alignment dashboard within the CliniSearch enterprise platform.
2. Select Policy for Review: The user selects the local "Community-Acquired Pneumonia (CAP) Management Protocol" from a list of Trust policies.
3. Initiate Comparison: The system automatically compares the local protocol against the current NICE guideline NG138 and relevant British Thoracic Society recommendations.
4. Review Results: The dashboard displays a traffic-light coded report:
   • Green (Aligned): Local criteria for hospital admission match NICE.
   • Amber (Divergent): Local antibiotic formulary specifies a different first-line agent than recommended nationally, with a note explaining the local antimicrobial stewardship rationale.
   • Red (Outdated): The local policy references a CURB-65 score threshold that was updated in the national guideline two years prior.
5. Action and Document: The user generates a divergence report, which is forwarded to the relevant clinical leads for review. The system logs this action, creating an audit trail that includes the date of review, the findings, and the responsible individual.

This workflow typically takes minutes rather than the hours or days required for manual comparison, while providing more comprehensive coverage and consistent application of comparison criteria. The system also allows for bulk processing, enabling governance teams to review alignment across multiple policies or an entire clinical specialty in a single operation.

Governance & Safety

Robust governance is fundamental to the tool's design, ensuring the integrity and safety of the alignment process.

Provenance

All national guidelines used for comparison are sourced directly from the publishing bodies' official websites. Each guideline is tagged with its publication date, version number, and a direct link to the source, providing full provenance and allowing users to verify the source material.

The system maintains a version history of all national guidelines, allowing users to see not only the current recommendation but also how it has evolved over time. This historical perspective can be valuable when understanding the context of local policy decisions that may have been made based on previous versions of national guidance.

Update Handling

The system monitors national sources for updates. When a new guideline is published, it automatically re-scans all mapped local policies and flags any newly created divergences for immediate attention, preventing policy lag.

Update alerts can be configured to notify specific individuals or teams based on clinical specialty or policy ownership. The system differentiates between major updates (which may require urgent review) and minor revisions, helping governance teams prioritise their response based on clinical impact.

Wording Controls

To prevent misinterpretation, the tool allows governance teams to add contextual notes to any flagged divergence. For example, a divergence can be tagged as "Clinically Justified Variation" with a free-text explanation of the local rationale (e.g., resource constraints, local population needs), ensuring the nuance behind policy decisions is captured.

The system supports structured tagging of divergence reasons, allowing organisations to categorise and analyse patterns in local variations. Common categories include resource limitations, local expertise considerations, population characteristics, and interim measures pending full implementation of national recommendations.

Audit Trail

Every action—from the initial policy upload and scan to the review of divergence reports—is logged with a timestamp and user identifier. This creates a comprehensive audit trail that demonstrates due diligence in maintaining policy alignment, which is crucial for CQC inspections and internal governance reviews.

The audit trail captures not only what actions were taken but also the evidence considered. For each policy review, the system records which version of national guidelines was used for comparison, providing a complete historical record of the alignment checking process that can be reconstructed if needed for regulatory or legal purposes.

Frequently Asked Questions (FAQ)

Implementation

How long does it take to implement the Local Guideline Alignment module?
Implementation typically takes 2-4 weeks. The process involves integrating with your document management system (if applicable), uploading your local policy library, and configuring the initial mapping to national guidelines. Our team provides full support throughout this setup phase.

Can the system handle policies from different clinical specialties?
Yes. The module is designed to work across all medical, nursing, and allied health professional specialties. The underlying knowledge base covers national guidance from a wide range of specialties, from cardiology to mental health.

What technical requirements are needed for implementation?
The module is cloud-based and accessible through standard web browsers. For document integration, we support common document management systems through API connections. No specialised hardware or software installation is required on your end, though we recommend assigning a clinical lead and an IT contact to facilitate the setup process.

Data Handling

Where is our local policy data stored and processed?
All data processing occurs within our UK-based, NHS Digital Data Security and Protection Toolkit (DSPT) compliant infrastructure. Your local policies are stored securely and are only used for the purpose of alignment checking within your organisation's instance of the platform.

Is the content of our local policies visible to CliniSearch staff?
Access to the content of your policies is restricted to authorised personnel within your organisation. CliniSearch technical staff may require access for troubleshooting purposes, but this is governed by strict data processing agreements and only occurs with your explicit permission.

How is data retention handled for uploaded policies?
Policy documents are retained for as long as they remain active in your system. When policies are updated or removed, previous versions are archived according to your organisation's retention policy. We can configure retention periods to match your specific governance requirements.

Limitations

Can the tool automatically update our local policies?
No. The tool is designed for intelligence and oversight, not autonomous action. It identifies discrepancies and provides reports, but the actual revision and approval of local policies must be carried out by the responsible clinical governance teams within your organisation, preserving clinical judgement and local accountability.

How does the system handle nuanced clinical judgement that isn't explicitly stated in a policy?
The tool analyses the written content of policies. It cannot interpret unwritten local practices or individual clinician discretion. Its primary value is in ensuring that the formal, written guidance that underpins practice is aligned with the national evidence base.

What types of divergence might the system not detect?
The system may not detect subtle differences in clinical reasoning or interpretation that don't manifest as clear textual discrepancies. It also cannot assess the practical implementation of policies in clinical settings. The tool complements but does not replace the critical oversight of experienced clinical governance professionals.

How current is the national guideline database?
Our database is updated within 24-48 hours of new guideline publications from major national bodies. However, there may be brief periods where very recent publications are being processed. The system clearly indicates the publication date of each national guideline used in comparisons.

Core capabilities