The IDIS Foundation warns that 85% of clinical guidelines are outdated.

The Clinical Practice Guidelines (CPGs) of the National Health System (NHS) are documents prepared by experts that offer recommendations based on the best available scientific evidence. Their main objective is to optimize health care, allowing medical professionals to make informed decisions based on the latest clinical evidence on the diagnosis, treatment, and prevention of diseases, ensuring high-quality care and maximizing the efficient use of resources. However, 85% of them have been published for more than five years , which means they cannot be considered up-to-date and valid.

Despite having 211 guidelines and 20 new ones being developed between 2022 and 2025, the number of current CPGs has decreased (from 34 to 31) and the number of outdated ones has increased by 3%, highlighting the risk of potential gaps. This is highlighted in the second edition of the report "Service Portfolio and Clinical Practice Guidelines" (Portfolio of Services and Clinical Practice Guidelines ), prepared by the IDIS Foundation (Institute for the Development and Integration of Healthcare). This report reflects a lack of updating of these key documents for evidence-based healthcare. This can lead to inequalities between autonomous communities, clinical variability, and barriers to incorporating technological innovation into the healthcare system.

The analysis reveals that the autonomous communities with the highest number of current CPGs , and those less than 5 years old, are Andalusia, Aragon, Catalonia, Madrid, and the Basque Country . By specialty, it shows that Pediatrics, Cardiology, Oncology, Gynecology, and Allergology do not have any guidelines published less than 5 years ago. Only Clinical Psychology, Psychiatry, and Family and Community Medicine have updated guidelines, albeit in very limited numbers.

The clinical guidelines are integrated into GuíaSalud—the organization that brings together all the guidelines of the National Health System (NHS)—and into the Health Technology Assessment Network (RedETS), which evaluates health technologies to ensure their effectiveness and safety in the NHS. Both organizations propose a methodological system for updating these documents, a process that is not currently being implemented. "It is essential to establish an agile, transparent, and coordinated system that guarantees the periodic updating of clinical practice guidelines. Only in this way can we offer patients safe, consistent care based on the best scientific evidence," emphasizes Marta Villanueva, general director of the IDIS Foundation.

The report shows that healthcare overload forces physicians to treat a large number of patients in a short timeframe, limiting their ability to implement CPGs. This is key to ensuring quality of care and minimizing risks that, in the long term, could lead to complications for patients and increased healthcare costs. Furthermore, it notes that failure to update CPGs can generate mistrust among physicians, as they do not reflect the latest advances. This can lead to the adoption of outdated approaches, affecting the quality of care and hampering decision-making, which could increase risks for patients.

Likewise, a lack of familiarity with CPGs can limit their application in clinical practice, which can lead to the use of less efficient approaches and affect the quality of care.

To reverse this situation, the IDIS Foundation proposes a comprehensive strategy focused on several key pillars: digitalization, access, and training . First, it proposes the need to develop a centralized, open-access digital repository that integrates both the most relevant national and international clinical guidelines. This system would allow for quick and easy access to up-to-date information from any point in the healthcare network.

Furthermore, it is proposed to advance the digitalization of the guidelines themselves, adopting structured and interoperable formats that can be accessed from electronic medical record systems and other digital platforms. This would facilitate their practical application in real time by healthcare professionals and strengthen their usefulness in clinical decision-making.

Another key proposal is the implementation of automated alert and notification systems to inform professionals about updates, modifications, or the incorporation of new recommendations. This system should be linked to official platforms and also rely on recognized international sources, such as NICE, AHRQ, and the WHO.

The IDIS Foundation also advocates for the creation of accredited continuing education programs linked to the correct interpretation and implementation of clinical guidelines. This training should be incentivized through continuous professional development systems and contribute to standardizing criteria throughout the healthcare system.

Finally, the report raises the need to establish objective criteria to prioritize which guidelines require urgent revision . These criteria should include clinical impact, epidemiological relevance, frequency of use, and cost-effectiveness, so that efforts are focused on those recommendations with the greatest impact on public health. "The rigorous, updated, and shared use of these tools not only improves the quality of care but also contributes to a more efficient, equitable, and patient-centered system," concludes Marta Villanueva.