CEU: Who are we? What do we do? And members – what’s in it for you?

Date: 03 Nov 2021

Have you ever wondered what our Clinical Effectiveness Unit (CEU) does exactly – and how this benefits you as a member? Katie Boog, Co-Director of our CEU shares an overview.

The first time I visited the Clinical Effectiveness Unit (CEU) was as a trainee, attending a Guideline Development Group meeting. I really wasn’t entirely sure what to expect. Who actually were the CEU team and what was their role? I knew they wrote the UKMEC; gave talks at conferences; wrote the guidelines I had studied until all hours preparing for my exams ... but were they clinicians? Were they doing the research themselves? Were they a clinical advice service? Other than expecting multiple offices and lots of staff, I wasn’t really sure what to expect.

Fast forward a few years and here I am, sitting in the CEU office, where I now work two days a week as Co-Director. So, if like ‘previous-me’ you have no idea who the CEU actually are, what they do and what they don’t do … read on and let me tell you all about us!

What is the CEU?

At the core of everything that the CEU does, is evidence. Our remit is to support evidence based clinical practice in SRH and so even though our clinical team are experienced SRH clinicians, our role is not to give expert opinion but to find the evidence, review and appraise it, and present it to other clinicians in a practical and meaningful way.

This generally involves an extensive literature review to identify what evidence is available, then reviewing that evidence to see whether or not the study is of good quality and is reliable. We then look at whether or not it is relevant for the specific group of people we are looking at and then take the evidence and package this into a clinically relevant summary for the clinician.

What do we do?

Work stream 1: Guideline Development – led by Chelsea Morroni

CEU work stream graph Work stream 1 is about our planned and scheduled guideline development. Each year, the CEU identify, scope and produce 3 or 4 new or updated guidelines. Each Director has responsibility for their own guideline and at any one time we will all be at different stages of guideline development. Chelsea leads on this work stream and as well as having her own individual guideline responsibility, she will also oversee, support and lead the team’s guideline development process.

This includes ensuring the quality of the guidelines, which are produced to NICE accredited standards; reviewing any gaps in guidance to identify new potential guidelines; and identifying any updates required for current guidance. Chelsea will also develop auditable outcomes for each new guideline to allow clinicians to audit their own practice.

This work stream also includes the UKMEC and next year we have the mammoth task of reviewing and updating this to ensure it is as comprehensive as possible and remains in line with any new evidence that has emerged since the current version was published.

Work stream 2: Responsive Guidance – led by Sarah Hardman

While work stream 1 is about planned and scheduled guidance, work stream 2 is about responding to unscheduled requests for evidence. This includes reviewing the credibility and relevance of any new studies or products that come out, and working with the external affairs team and the media to respond to any emerging events or news items.

This work stream also includes the Member’s Evidence Request Service (MERS) and we get around 10 of these requests per week. If you are an FSRH member, you can use the MERS as one of your free membership benefits. This means you can contact the CEU for information about a particular contraception issue not covered in the guidelines, e.g. whether or not a method of contraception would be suitable for a person with an unusual medical condition.

We then review all available evidence (which could be hundreds of studies or a few) and summarise it to save you having to do a literature review and appraisal yourself. The important thing to remember is that the advice we give is not our own personal advice, but is a summary of the available evidence.

If the evidence is limited or conflicting (or absent!) then you will still need to use your own clinical judgement or seek advice from your local SRH expert. As much as we would sometimes love to give you our clinical opinion, we can’t, because we are not in our clinical role, we are in our CEU role, and that role is to give you the evidence (or lack thereof) and not our opinion. And in order to ensure the credibility of the CEU and FSRH we have stick to that.

Work stream 3: Guidance dissemination and related education – led by Katie Boog

CEU image 2 Our guidelines are very comprehensive, which usually means they are long. This is necessary, to show why recommendations have been made, but we know that different clinicians will use our guidelines in different ways. While one might just need to quickly check the flowchart to see whether or not emergency contraception is suitable for their patient, another might be needing to learn the minutiae of the guideline for their exams.

So, as we appreciate not everyone has time to read the whole guideline, we also provide a support package of materials to accompany each guideline – as a benefit available for our FSRH members. This includes a Quick Reference Summary and a free webinar to tell you everything you need to know about the guideline in around 30 minutes. We also write summary articles for journals and blogs for the FSRH website, and will present updates at FSRH and other partner organisation conferences.

Alongside our 3 core work streams, we also provide support for FSRH by creating member benefits, representing FSRH and CEU on various committees and reviewing non-CEU products to ensure they are in line with current guidance and a consistent message is going to clinicians and patients.

Who are we?

CEU staff graph Our clinical team includes myself (a consultant in CSRH); Sarah Hardman (a senior specialty doctor in SRH); Chelsea Morroni (an epidemiologist, a specialty doctor in SRH and an international expert in academic SRH); and Claire Nicol, an Advanced Nurse Practitioner in SRH. Our non-clinical team includes Eric Chen, our senior researcher; Cat Carver, our medical researcher; and Helen Carrington-Riebicke, our project administrator.

Despite these various work streams and roles, we are a small team (certainly nothing like the vast office of staff I had previously imagined!) who all work in other services as well as for the CEU. In terms of the hours we work, we are the equivalent of 1.2 full time clinicians and a 1.1 full time researcher, so we are kept very busy!