Abstract

Background. Little is known about the attitudes and behaviour of British general practitioners towards clinical guidelines.
Aim. To investigate the beliefs, attitudes and behaviour of general practitioners towards clinical guidelines.
Method. A postal questionnaire sent to all 326 general practitioner principals on the list of Lincolnshire Family Health Services Authority in 1994.
Results. Of the 326 general practitioners sent questionnaires 213 (65.3%) replied. Most respondents (78.4%) had written, or participated in writing, practice-based guidelines. An even greater proportion (92.0%) had participated in clinical audit. The majority of respondents felt that guidelines were effective in improving care (68.5%). Members (and fellows) of the Royal College of General Practitioners had a more positive attitude towards guidelines. They were significantly more likely to have written in-house guidelines as were those who had participated in audit. There was no evidence of change in attitude after participating in an inter-practice audit.
Conclusions. Practice-based guidelines are widely used in Lincolnshire. This use is largely sustained by positive beliefs about their effectiveness and benefits. Practitioners were ambivalent about the use of guidelines for setting performance-related pay and their effect on professional status. They were concerned that guidelines should be scientifically valid and valued local “ownership” of guidelines. The positive attitude of its members supports the college in its continuing role in developing guidelines in primary care. Incorporation into clinical audit may also be an effective way of disseminating systematic research-based guidelines.