Background

At the BSCOS AGM in Norwich, 2019, the membership voted in favour of a programme for BSCOS to establish guidelines for the management of common children’s orthopaedic conditions. The guides should be consensus driven, not prescriptive and it is anticipated that they will contribute to reducing unjustifiable idiosyncratic variation in practice and might also support appraisal, the GIRFT process and promote education.

Consensus Steering Groups have been created for three areas of practice where consensus might be achieved most easily, namely:

• Management of DDH before 3 months old.
• Early management of osteo-articular infection in children.
• Management of clubfoot in the neonatal period.

The process will follow a Delphi approach. For the history and application of the Delphi process see the links below:

https://en.wikipedia.org/wiki/Delphi_method

https://www.healthknowledge.org.uk/public-health-textbook/research-methods/1c-health-care-evaluation-health-care-assessment/use-delphi-methods

The process will be as follows: -

1. The steering group meets to brainstorm and agree a management guide for the specified condition.
2. The literature is checked to ensure there is no evidence conflicting the proposed guide.
3. The guide is circulated to BSCOS members with a series of questions to survey and score using “degree of agreement”.
4. The group refines the guide depending on feedback from membership
5. The refined guide is recirculated for further scoring
6. A “widely accepted” guide is developed and published.

Progress and agreed statements will be reported here on the BSCOS website.

For any queries regarding the process or the groups please contact consensus@bscos.org.uk