NICE vs SIGN (2025): England vs Scotland Guidelines

Last reviewed: 2025-12-19 · Reviewed by

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At a Glance

Who is it for?

NICE:NHS England/Wales

SIGN:NHS Scotland

Why choose NICE?

  • **Scope**: Covers Health, Social Care, and Technology Appraisals.
  • **Updates**: 'Living Guidelines' are updated rapidly.
  • **Legal**: Formularies in England are legally bound to follow NICE TAs.

Why choose SIGN?

  • **Rigour**: Famous for its strict evidence-based methodology.
  • **Stability**: Guidelines are static documents (easier to reference).
  • **Patient Focus**: Strong emphasis on patient involvement in drafting.

Feature Comparison

CapabilityNICESIGN
JurisdictionEngland & WalesScotland
VolumeHigh (Hundreds)Low (Targeted)

In-Depth Analysis

Overview

For most conditions, NICE and SIGN agree. However, in specific areas (historically Asthma and Diabetes), they have proposed different pathways. NICE is broader, covering social care and public health. SIGN is deeper, producing fewer guidelines but with intense methodological rigour.

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Use-Cases

Working in London

When to choose NICE

  • **Mandatory.**

When to choose SIGN

  • Reference only.

Working in Glasgow

When to choose NICE

  • Reference.

When to choose SIGN

  • **Mandatory.**

Asthma Management

When to choose NICE

  • BTS/SIGN and NICE historically differed.

When to choose SIGN

  • **Note:** The 'British Thoracic Society' often aligns with SIGN.