How we keep content safe
What sits behind every pathway, protocol and case: where the evidence comes from, when each page was last checked, how often it is due again, and what happens when you tell us something is wrong.
The short versionEvery page tells you its own status
There is no single badge on this site that says "all our content is reviewed", because that would not be true and a badge like that is worth nothing anyway. Instead every clinical page carries a provenance strip under its title stating when it was last checked, when it is next due, and which guidance it is anchored to. If a page has not had a named clinical sign-off, it says so on the page.
Status is shown as a word and a symbol as well as a colour, so it is readable without colour vision. The same strip links every page to the guidance it draws on and to the form for telling us something is wrong.
Where the library stands today. The 211 management protocols, 200 diagnostic algorithms and 108 casebook cases were read through and signed off on 20 September 2026, and now carry that date in their strip. The clinical lead accountable for that sign-off is named above.
High-risk pages then come round again at six months and everything else at twelve, so the first re-reviews fall due in March 2027. A page added after that date carries no sign-off until it has one, and says so.
Evidence standardWhich sources we use, and in what order
UK primary care has a clear hierarchy and we follow it rather than assembling our own. Where two sources disagree, the higher one wins and the disagreement is stated on the page rather than quietly resolved.
| Order | Source | How we use it |
|---|---|---|
| 1 | NICE guidelines and NICE CKS | The default anchor for thresholds, referral criteria and management sequence. Recommendation numbers are quoted where a page states a specific threshold. |
| 2 | BNF and BNFC | The only authority for doses. We deliberately do not restate doses that belong in the BNF — every prescribing page defers to it and says so. |
| 3 | MHRA Drug Safety Update | Overrides everything above it on safety restrictions, contraindications and warnings, from the date of issue. |
| 4 | NHS England, UKHSA | Service specifications, screening programmes, immunisation and communicable disease management. |
| 5 | Royal College and specialty guidance | RCGP, RCOG, RCPCH, BSG, BASHH, BTS/SIGN, BSR, FSRH and equivalents, where NICE is silent or less specific. |
| 6 | Primary literature | Only to explain a number a clinician will be asked about, never to override a national recommendation. |
Guidance that has changed or been withdrawn
When a source is withdrawn, superseded or placed under review, the page says which recommendation is affected and what we have done, rather than silently deleting the line. A page whose anchor guidance is mid-revision is flagged Review due regardless of its date.
National guidance is not your local pathway
Everything here is national guidance. Referral routes, direct-access investigations, antimicrobial choices and formulary preferences are set locally by your ICB, area prescribing committee or trust, and they routinely differ from the national default. Every clinical page carries this caveat in its footnote. Where your local pathway differs, your local pathway is the one that applies.
Review cyclesHow often a page comes round again
| Tier | Cycle | What it covers |
|---|---|---|
| High risk | 6 months | Anything where a missed threshold causes serious harm quickly: suspected cancer and the two-week-wait criteria, sepsis, chest pain and ACS, anticoagulation, insulin and diabetic emergencies, hyperkalaemia, AKI, cauda equina and spinal cord compression, meningitis, stroke and TIA, anaphylaxis, suicidal ideation, safeguarding, ectopic pregnancy, testicular torsion, PE and DVT. |
| Standard | 12 months | Everything else, brought forward whenever its anchor guidance changes. |
| Out of cycle | Immediate | Any MHRA safety alert, NICE update or reader report affecting a published threshold, dose or referral criterion. |
Cycles run from the last recorded sign-off, not from publication. A page's tier is shown in its provenance strip.
CorrectionsIf something here is wrong, tell us
Every clinical page has a Report a concern link in the strip at the top. It opens a message pre-filled with the page address so you only have to describe the problem. You do not need to be sure — a suspicion is worth reporting.
| Severity | What it means | Our response |
|---|---|---|
| Critical | Could cause serious harm now — a wrong dose, a missed red flag, an incorrect emergency threshold. | Page amended or withdrawn same working day. Acknowledged to the reporter with what changed. |
| Major | A referral criterion, monitoring interval or contraindication that is wrong or out of date. | Amended within 5 working days. |
| Moderate | Guidance has moved on and the page has not, without immediate risk. | Amended at the next scheduled review, or sooner. |
| Minor | Typography, a broken link, an unclear sentence. | Logged and fixed in the next routine pass. |
A page that cannot be corrected quickly is flagged or withdrawn rather than left standing. Correction always beats defending what is published.
Who is accountableThe people behind the content
Reasoning GP is a small, GP-led independent project rather than a large editorial organisation, and we would rather describe that accurately than imply a structure we do not have.
Clinical lead and responsible author: Dr Bassam Mohamed, practising UK GP. Accountable for clinical content, sign-off and corrections.
Independent clinical review: to be confirmed — the roles this work needs next are an independent reviewer for high-risk pages and a medicines-safety reviewer for prescribing content. We will name them here when they are in post, and not before.
Independence: no advertising, and no pharmaceutical or commercial sponsorship of clinical content.
BoundariesWhat this platform is not
- Not a medical device. Reasoning GP publishes educational and reference content. It does not make recommendations about an individual patient, and we make no regulatory claim of any kind. Any future feature that produced patient-specific output would require specialist regulatory advice before release.
- Not a substitute for clinical judgement, your local protocol, or emergency assessment. In an emergency, call 999.
- Not a prescribing authority. Check every dose in the current BNF or BNFC before prescribing.
- Not for patients. The content is written for qualified UK healthcare professionals and doctors in training.
- Not a source of truth for AI output. Where a feature uses AI it is labelled, and the same rule applies: verify before acting. See the medical disclaimer.
Keeping upHow guideline changes reach the library
MHRA Drug Safety Update, UKHSA and NICE feeds are monitored and surfaced on the Updates page. A change that affects a published threshold triggers an out-of-cycle review of the pages that cite it, which is why the review date on a page can move before its cycle is up.