Close menu


Sunderland Repository records the research produced by the University of Sunderland including practice-based research and theses.

Is Scottish Intercollegiate Guidelines Network guidance for GP management of tonsillitis suitable? A qualitative study

McSweeney, Lorraine A, Wilson, Janet A, Wilkes, Scott and Haighton, Catherine A (2018) Is Scottish Intercollegiate Guidelines Network guidance for GP management of tonsillitis suitable? A qualitative study. Family Practice, 35 (5). pp. 633-637. ISSN 0263-2136

Item Type: Article


Background The Scottish Intercollegiate Guidelines Network developed guidelines for the management of sore throat and indications for tonsillectomy in 1999 to address concerns of unnecessary surgery. Emergency admissions to hospital for tonsillitis have since increased. Adults experience an average of 27 episodes of tonsillitis before undergoing tonsillectomy. We wished to explore the appropriateness of the guidance and/or its implementation in primary care Aim To explore the attitudes of GPs to the referral criteria they use when managing adults presenting with acute tonsillitis. Design Secondary analysis of qualitative data from the NAtional Trial of Tonsillectomy in Adults (NATTINA) feasibility and process evaluation. Participants and setting Twenty-one GPs from practices throughout the UK. Method In-depth interviews GPs concerning both the feasibility and process evaluation phases of NATTINA. Analysis was conducted using the Framework method. Results General practitioners felt it was rarely necessary to refer patients. They were aware of guidelines and would refer if requested by a patient who fulfilled the guidelines criteria and/or who were missing considerable amounts of work. Conclusion The introduction of the guidelines appears to coincide with what some may have hoped to be a desired effect of reducing adult sore throat referrals and subsequent tonsillectomies by increasing the number of episodes a patient must suffer before the referral threshold is met. GPs may find equipoise for tonsillectomy referral challenging as many patients, express a strong preference for surgery.We believe this paper reinforces GP professionalism, patient-centred consultations and challenges the role of clinical guidelines.

[img] PDF
10779 2018 FAMILY PRACTICE NATTINA SIGN.pdf - Published Version
Restricted to Repository staff only
Available under License Creative Commons Attribution No Derivatives.

Download (110kB) | Request a copy
is sign guidance suitable.pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (423kB) | Preview

More Information

Depositing User: Michelle Marshall


Item ID: 10779
Identification Number:
ISSN: 0263-2136
Official URL:

Users with ORCIDS

ORCID for Scott Wilkes: ORCID iD

Catalogue record

Date Deposited: 16 May 2019 13:19
Last Modified: 30 Sep 2020 11:04


Author: Scott Wilkes ORCID iD
Author: Lorraine A McSweeney
Author: Janet A Wilson
Author: Catherine A Haighton

University Divisions

Faculty of Health Sciences and Wellbeing



Actions (login required)

View Item (Repository Staff Only) View Item (Repository Staff Only)