NHS Plus must learn from the Netherlands on clinical guidelines

NHS Plus can learn about how to include workplace issues in clinical guidelines from the Netherlands, which has standards in a range of clinical areas, delegates heard.


Work issues have been incorporated in clinical guidelines in the Netherlands since 2004 by the Netherlands Society of Occupational Medicine (NVAB), said Dr Carel Hulshof, associate professor at the Cornonel Institute in Amsterdam.


Hulshof said the guidelines recognised the time pressures on occupational health physicians and GPs, and gave them the benefit of collective research.


“It’s not always possible in our work hours or busy lives to do these sort of search actions,” he said. “No-one can afford to read for four or five hours a day just to get all the relevant articles.”


Clinical areas covered include lower back pain, mental health, upper limb disorders, contact dermatitis, hearing loss, pregnancy and asthma.


The guidelines are based on three questions:




  • Are work-related disorders or disabilities related to the subject of this guideline?


  • Are work-related interventions positive and effective?


  • What is the role of occupational healthcare?

Hulshof acknowledged that there was a lack of high-level evidence on work-related interventions, but said that sometimes more general evidence of good practice can be used.


Dr Ira Madan, NHS Plus clinical director, said the National Institute for Health and Clinical Excellence (NICE) could follow the approach. “We ought to be pushing NICE in this direction,” she said.

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