Guidelines development

Process Manual

Approved by Resuscitation Council UK Board of

Trustees and Executive Committee

Publication date: January 2021

More information on accreditation can be viewed at

www.nice.org.uk/accreditation
Contents
Contributors ........................................................................................................................................ 3

Executive summary .......................................................................................................................... 5

1. Introduction .................................................................................................................................... 7

1.1 About Resusitation Council UK……………………………………………………………...7

1.2 Resusitation Council UK Guidelines ............................................................................. 7

1.3 Quality standards for clinical practice and training........................................................ 8

1.4 Structure of the Resuscitation Council UK.................................................................... 8

2. Development process .................................................................................................................. 9

2.1 Topic selection ............................................................................................................. 9

2.2 Establishing working groups ........................................................................................ 9

2.3 Scope and purpose .................................................................................................... 10

2.4 Rigour of development ............................................................................................... 11

3. Presentation ................................................................................................................................. 13

4. Implementation ............................................................................................................................ 15

5. Evaluation ..................................................................................................................................... 16

6. Updating of guidance ................................................................................................................. 16

7. Editorial independence.............................................................................................................. 17

Appendices ....................................................................................................................................... 18
Appendix 1 - Organisational chart and statistics............................................................... 18
Appendix 2 - Guidance on conflict of interest (COI) ......................................................... 19
Appendix 3 - House style guide ....................................................................................... 22
Appendix 4 - Statement of editorial independence ........................................................... 22
Appendix 5 - Step by step process for developing Resuscitation Council UK CPR
Guidelines........................................................................................................................ 24
Appendix 6 - RCUK equality impact assessment tool....................................................... 27
Appendix 7 - Conflict of interest statements of manual authors ........................................ 28
Appendix 8 - Guidance for co-authorship, endorsement and support of publications ....... 30
Appendix 9 - References ................................................................................................. 36

RCUK Guidelines development process manual 2

Contributors
Original contributors
Dr Jasmeet Soar,
Consultant in Anaesthesia and Intensive Care Medicine, Southmead Hospital, North Bristol
NHS Trust, Bristol BS10 5NB
Chair, Resuscitation Council UK Guidelines 2015 Working Group
Chair, Resuscitation Council UK Standards Working Group
Chair, Resuscitation Council UK Anaphylaxis Working Group.

Sarah Mitchell,
Director, Resuscitation Council UK
5th Floor Tavistock House North, Tavistock Square, London WC1H 9HR.

Dr Carl Gwinnutt,
Emeritus Consultant
Salford Royal Hospital NHS Foundation Trust, Salford M6 8HD
Vice-Chair, Resuscitation Council UK.

Dr Ian Bullock,
Chief Operating Officer, National Clinical Guideline Centre,
Royal College of Physicians, St Andrews place, Regents Park, London NW1 4LE.

Viv Cummin,
Lay member, Resuscitation Council UK Patient Advisory Group.

RCUK Guidelines development process manual 3

Reviewers for 2020 update
Dr Jasmeet Soar
Chair ALS Subcommittee
Consultant in Anaesthesia and Intensive Care Medicine, Southmead Hospital, North Bristol
NHS Trust, Bristol BS10 5NB

Sue Hampshire
Director of Clinical and Service Development, Resuscitation Council UK
5th Floor Tavistock House North, Tavistock Square, London WC1H 9HR.

Prof Jonathan Wyllie

President Resuscitation Council UK
Consultant in Neonatology, James Cook University Hospital, Marton Road, Middlesbrough.
TS4 3BW

Dr Andrew Lockey
Vice-President Resuscitation Council UK
Consultant in Emergency Medicine, Calderdale and Huddersfield NHS Trust, Acre Street,
Huddersfield. HD3 3EA

Elizabeth Yeates
Patient public representative

Kevin Mackie
Lead Educator Resuscitation Council UK
5th Floor Tavistock House North, Tavistock Square, London WC1H 9HR.

RCUK Guidelines development process manual 4

Executive summary
1. This development process manual:
• describes the process used by Resuscitation Council UK [RCUK] to develop and
update its guidelines and standards consistent with global evidence methods
• provides details of the technical aspects of guideline development and the methods
used
• supports and directs all those who are tasked with developing or updating RCUK
guidelines and standards
• ensures that quality assurance is key to this process
• ensures stakeholder engagement is at the heart of the process
• ensures that transparency is illustrated in the process used by RCUK to develop its
guidelines and standards work programme.

2. All those involved in the production of RCUK guidelines, standards and statements will
be required to follow the process described in this manual. The Process is summarised in
Figure 1.

3. This manual replaces: Resuscitation Council UK Guidelines Development Process

Manual. July 2014, amended December 2014 http://www.resus.org.uk/resuscitation-
guidelines/

RCUK Guidelines development process manual 5

Figure 1. Summary of Resuscitation Council UK Development Process

RCUK Guidelines development process manual 6

1. Introduction
1.1 About Resuscitation Council UK (RCUK)
RCUK was formed in August 1983. The objective of the Council was, and still is, to facilitate
education of both lay and healthcare professional members of the population in the most
effective methods of resuscitation appropriate to their needs and to ensure appropriate
resuscitation for all. This includes conversations and planning in advance of need. RCUK
aims to achieve its objective by:
• encouraging research into methods of resuscitation to create new knowledge
• leading evidence synthesis of published research to guide contemporary practice
• studying resuscitation teaching techniques
• establishing appropriate guidelines for resuscitation practice
• promoting the teaching of resuscitation using the established guidelines which remains a
key implementation strategy of evidence-based guidelines
• establishing and maintaining standards for resuscitation
• fostering good working relations between all organisations involved in resuscitation
• producing and publishing teaching materials and literature associated with the
organisation of resuscitation
• promoting and facilitating conversations and decision making
RCUK organisational chart is shown in Appendix 1.

1.2 Resuscitation Council UK Guidelines

RCUK adheres to the definition and standards set out by the Institute of Medicine:
Clinical practice guidelines are statements that include recommendations intended to
optimise patient care that are informed by a systematic review of evidence and an
assessment of the benefits and harms of alternative care options.
Consensus report, Institute of Medicine. Clinical practice guidelines we can trust. March 23,
2011.
www.ncbi.nlm.nih.gov/books/NBK209539/ (Accessed 27 January 2021)

RCUK guidelines are based on the best available evidence and are relevant to healthcare
professionals, health service managers, patients, their families and carers, and lay persons
involved in resuscitation. They provide source material for optimal implementation of
evidence-based recommendations in shaping nationally recognised courses, focused on
improving both the outcomes and an individual’s experience of care.

RCUK has a long history of developing nationally accepted guidelines for cardiopulmonary
resuscitation (CPR):
• Basic life support (BLS)
• Use of an automated external defibrillator (AED)
• Advanced life support (ALS)
• Paediatric life support (PLS)
• Newborn life support (NLS)
• Education
• Ethics

RCUK Guidelines development process manual 7

RCUK is committed to improve the quality of care and outcomes for those individuals who
need resuscitation. This involves recommendations on managing: a ‘deteriorating patient’,
‘cardiac arrest’ and ‘post cardiac arrest care’. This is achieved by the guidelines providing
healthcare professionals and lay people with evidence-based clinical pathways for all patient
groups (adults, children, newborn) in all settings. Our guidelines are the basis for
resuscitation care throughout the UK.

RCUK will also produce guidance in other subject areas related to resuscitation as required
(e.g. Guidance for cardiac arrest in times of COVID-19 pandemic)

All RCUK guidelines are freely available at www.resus.org.uk.

1.3 Quality standards for clinical practice and training

RCUK also produces quality standards for clinical practice and training, the aim of which is to
improve care and outcomes for patients who are deteriorating or suffer cardiorespiratory
arrest in a healthcare setting. There is a particular emphasis on simplification and
standardisation to improve implementation and delivery of resuscitation care. Specifically,
they:
• aim to lead to improvements in patient care and local resuscitation services
• are derived from existing guidance from RCUK and other bodies
• are written in collaboration with stakeholders
• have outcomes that can be measured either locally or as part of national audits.

The development of these standards follows the same rigorous process as for guidelines
produced by RCUK. All RCUK standards are freely available at www.resus.org.uk.

1.4 Structure of the Resuscitation Council UK

RCUK comprises:
• a Board of Trustees; this consists of elected Trustees (President, Vice President,
Honorary Treasurer, Honorary Secretary) and three appointed Trustees
• an Executive Committee; this consists of clinicians from a range of specialities, the lead
educator, chairs of subcommittees, stakeholder representatives and patient/public
representatives
• Subcommittees
• Patient /public advisors. E.g. Sudden Cardiac Arrest UK
• Working groups; these are ‘task and finish’ groups for specific project areas
• a paid body of staff led by the Chief Executive Officer and Senior Management Team

RCUK Guidelines development process manual 8

2. Development process
The objective of this development process manual is to clarify and delineate the methods,
principles, and processes used by RCUK to develop its guidelines and standards for use in
the UK.

2.1 Topic selection

RCUK will produce:
1. Cardiopulmonary resuscitation guidelines on subjects including basic life support (BLS),
use of an automated external defibrillator (AED), advanced life support (ALS), paediatric
life support (PLS), ethics, epidemiology, neonatal life support (NLS) and education. The
principle aim of these guidelines is to improve the quality of patient care and outcomes
from cardiac arrest. RCUK guidelines, distilled from the ERC guidelines, provide
healthcare professionals and laypeople with evidence-based clinical pathways for all
patient groups (adults, children, newborn) and all settings. The scientific evidence
supporting RCUK guidelines is reviewed every 5 years (most recently in 2015). Since
2017 ILCOR has commenced a continuous evidence evaluation process which will
inform but not change the process for guidelines 2020.
2. Emergency treatment of anaphylaxis guidelines, updated every 5 years if necessary. The
most recent version was first published in 2008 and was reviewed in 2020.
3. Quality standards for cardiopulmonary resuscitation practice and training in clinical
settings (acute care, primary care, mental health inpatient, primary dental practice,
community care). First published in 2013, updated versions have been published when
new evidence or information has become available.
4. Guidance on specific topics relating to resuscitation (e.g. Cardiovascular Implanted
Electronic Devices in people towards the End of Life, during Cardiopulmonary
Resuscitation and after Death, Safer handling during resuscitation, Management of
cardiac arrest during neurosurgery in adults). Most topics are chosen based on emerging
issues or following liaison with other organisations. The final decision rests with the
RCUK Executive Committee.

2.2 Establishing working groups

1. RCUK will establish working groups to develop guidelines and standards.
2. All members of the working group must adhere to the RCUK conflict of interest (COI)
policy. Members will not acquire any financial gain or facilitate financial gain to others by
being a member of the working group.
3. The Chair of each working group will usually be a member of the Executive Committee
and appointed by the Executive Committee.
4. Other members of the working group will be appointed to ensure representation of all
relevant stakeholder groups including:
• subject matter experts
• methodology experts
• user groups
• patient or carer representatives.
5. Where appropriate, the working group can appoint proxy membership from relevant
specialist organisations, patient groups, colleges, and professional associations.

RCUK Guidelines development process manual 9

6. Working group members from relevant stakeholders will be identified by RCUK by
consulting its committees and subcommittees, membership, other stakeholder
organisations, and patient groups.
7. The patient, family or carer members could be from RCUK Patient Advisors, or members
of Sudden Cardiac Arrest UK. These members have equal status with other members of
the group.
8. The working group can add further individuals if gaps in the expertise of the working
group are identified.
9. RCUK will provide administrative support for the process.
10. RCUK will cover reasonable travel costs for working group members.
11. Working group members will be expected to commit to the whole process, attend
meetings and conference calls and respond to all email communications in a timely
manner unless there are extenuating circumstances.
12. The working group chair is responsible for:
a. working with RCUK staff to plan meetings
b. ensuring all working group members contribute to the discussions and activities of the
group
c. ensuring all members declare any new conflicts of interest since their last declaration,
and handling of any conflicts as they arise in line with the RCUK COI policy
d. steering the discussions according to the agenda
e. summarising the main points and key decisions from the debate
f. signing off meeting minutes once approved by the working group
g. leading the writing process and implementation of the final guideline or standard.

2.3 Scope and purpose

The working group will establish the scope of the guidance. The term guidance has been
used generically to cover the range of guidelines and standards listed in section 2.1.
1. The scope must give an overview of what will and will not be covered.
2. The scoping process should follow 4 stages:
a. identifying key issues and first draft
b. working with stakeholders to ensure key issues are not missed. Stakeholders can
help identify priority areas, and those areas where guidance already exists or is
lacking
c. consultation on the scope
d. finalising the scope.
3. The final scope must state:
a. the overall objective of the guidance
b. the clinical, healthcare or social questions covered by the guidance
c. the population and/or target audience to whom the guidance applies, (e.g. the
Anaphylaxis guidelines clearly state the intended users are healthcare staff)
d. the healthcare settings to which any guidance applies
e. the methods that will be used to evaluate the available evidence (e.g. systematic
review process)
f. the likely timescale for development and consultation
g. any equality issues that are identified.

RCUK Guidelines development process manual 10

4. The working group should establish the timeline for comments on the scope, (e.g.
stakeholders in advance of writing the guidance agreed the date of 2014 in the
Cardiovascular Implanted Electronic Devices in people towards the End of Life, during
Cardiopulmonary Resuscitation and after Death document scope).
5. The working group should update the scope based on comments received during the
consultation.
6. The scoping process may identify additional stakeholder groups. In such circumstance,
the working group membership may be updated.
7. The final scope and purpose should include a proposed timeline for the development
process that informs a work plan.

2.4 Rigour of development

1. RCUK was a founding member of the European Resuscitation Council through which it is
a member of the International Liaison Committee on Resuscitation (ILCOR) which
publishes International Consensus on Science with Treatment Recommendations
(CoSTR) documents based upon systematic reviews of PICOs (Population, Intervention,
Comparator(s) and Outcomes) using the GRADE (Grading of Recommendations,
Assessment, Development and Evaluation) process. This process incorporates public
consultations on all CoSTRs (https://costr.ilcor.org). The RCUK guidelines process builds
upon and incorporates these reviews ensuring that they are relevant and appropriate to
UK practice and patients.
2. RCUK CPR and anaphylaxis guidelines follow the GRADE working group
(https://www.gradeworkinggroup.org/). This system was developed by an international
working group to rate the certainty of evidence across outcomes in systematic reviews
and guidelines that examine alternative management strategies or interventions; these
may include no intervention or current best management. It can also be used to grade
the strength of recommendations in guidelines. The key difference from other
assessment systems is that GRADE rates the certainty of evidence for a particular
outcome across studies and does not rate the quality of individual studies.
3. Even, when there is little or no high certainty evidence, or no existing guidance (e.g.
Safer handling during resuscitation), the working group should follow Evidence to
Decision framework as recommended by GRADE.
4. In order to apply GRADE, the evidence must clearly specify the relevant setting using the
PICO format. Review questions for systematic review will be developed from the scope.
Questions can be about interventions, diagnosis and prognosis, based on the PICO
format and will inform a protocol that determines evidence synthesis approach (e.g.
outcome data extracted).
5. Details and dates of the search strategy including search terms, date of search,
databases searched, and numbers of studies included and excluded should be included
as an appendix to the guidance.
6. The working group will use existing systematic reviews or those from other organisations
where these exist (e.g. the 2020 anaphylaxis guidelines used up to date Cochrane
reviews, and the lead author of these systematic reviews was a member of the
Anaphylaxis working group). When systematic reviews from other organisations are
used, ensure they are conducted and reported according to AMSTAR (Assessing the
methodological quality of systematic reviews http://amstar.ca/index.php) and PRISMA
(Preferred Reporting Items for Systematic Reviews and Meta-Analyses www.prisma-

RCUK Guidelines development process manual 11

 statement.org/index.htm) recommendations, are in the public domain and have been
peer reviewed. The RCUK process follows the GRADE Evidence to Decision (EtD)
frameworks for adoption, adaptation, and de novo development of trustworthy
recommendations:
GRADE-ADOLOPMENT
GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo
development of trustworthy recommendations: GRADE-ADOLOPMENT.
Schünemann HJ, Wiercioch W, Brozek J, Etxeandia-Ikobaltzeta I, Mustafa RA, Manja V,
Brignardello-Petersen R, Neumann I, Falavigna M, Alhazzani W, Santesso N, Zhang Y,
Meerpohl JJ, Morgan RL, Rochwerg B, Darzi A, Rojas MX, Carrasco-Labra A, Adi Y,
AlRayees Z, Riva J, Bollig C, Moore A, Yepes-Nuñez JJ, Cuello C, Waziry R, Akl EA.
J Clin Epidemiol. 2017 Jan;81:101-110. doi: 10.1016/j.jclinepi.2016.09.009. Epub 2016
Oct 3.
7. Specifically RCUK CPR guidelines are based on an international process coordinated by
ILCOR (International Liaison Committee on Resuscitation) and the European
Resuscitation Council. See Appendix 5 for further details of the ILCOR Consensus on
Science and Treatment Recommendations (CoSTR) process.
8. Criteria and reasons for inclusion or exclusion of evidence identified by the evidence
review should be clearly stated.
9. The strengths and limitations of the body of evidence, and acknowledgement of any
areas of uncertainty, should be clearly stated.
10. The working group will ask stakeholders and its members to submit any evidence they
are aware of, so that any ‘grey’ literature is part of its review. The ‘grey’ literature includes
reports that are not formally published or have limited distribution and may not be
identified by a systematic review.
11. The method used to arrive at recommendations is based on review and discussion of the
evidence by the working group using an evidence to decision framework until consensus
is achieved. In most cases, this will be through a process of informal consensus. The
Chair must ensure that each individual on the working group can present and debate
their views, and that discussions are open and constructive. All members of the group
need to agree to endorse any recommendations. If the group cannot come to consensus,
this should be made clear in the final wording of the recommendation.
12. Agreeing recommendations may be based on formal consensus methods. When this
occurs a nominal group method will be used (i.e. the available treatment options are
discussed and then ranked by the group). This allows the views of all the members of the
group to be taken into account. The specific technique used is outlined in: Jones J,
Hunter D. Consensus methods for medical and health services research. BMJ
1995;311:376-80. A common issue for disagreement is whether there is a good enough
reason to change existing guidance, especially where there are important implementation
issues (e.g. additional cost of equipment, training needs).
13. Cost impact and ease of implementation should be considered when making
recommendations (e.g. the use of atropine was no longer recommended in the 2010
CPR guidelines based on no supporting evidence for or against its use in cardiac arrest).
14. The final draft of any guidance will be subject to stakeholder consultation. The duration of
this consultation period is determined by the working group and agreed by the Executive
Committee. The working group must actively ensure stakeholders are aware of the
consultation through the working group members, stakeholders, the RCUK newsletter,
website, and members of the Executive Committee (includes patients/family, clinicians).

RCUK Guidelines development process manual 12

15. Comments from stakeholders will be reviewed by the working group. Changes to the
guidance will be based on feedback using the same consensus process as for when
making initial recommendations (point 11 above). All feedback must be reviewed and the
reasons for acting or not acting on the feedback recorded.
16. The final guidance will be peer reviewed and quality assured by the RCUK Executive
Committee, which comprises up to 27 individuals including patients/family and
representatives of key stakeholder groups. This is ratified by the Trustees.

3. Presentation
1. The layout, presentation and style should follow RCUK house style guide and RCUK
Branding guidelines, Appendix 3
2. The presentation will include:
a. title page
b. summary
c. summary algorithm(s) when appropriate
d. when the guideline is an update, summary details of what has been updated
e. list the authors and their affiliations
f. the methodology and process
g. a description of how stakeholders, the public and others were able to view and
comment on the document
h. the objectives of the guidelines including scope and purpose, target audience and
target population are described
i. evidence statements
j. recommendations
k. links to supporting evidence (e.g. systematic reviews)
l. references
m. measurable outcome when appropriate (e.g. the National Cardiac Arrest Audit
(NCAA) for in-hospital cardiac arrest, www.icnarc.org/Our-Audit/Audits/Ncaa/About,
The Out-of-Hospital Cardiac Arrest Outcomes study for out-of-hospital cardiac arrest
https://warwick.ac.uk/fac/sci/med/research/ctu/trials/ohcao/)
n. links to related guidance and other supporting materials
o. statement of editorial independence Appendix 4
p. declaration of COI. The form is shown in Appendix 2
q. acknowledgements to those who have supported the development of the document
r. contact details for queries and feedback.
3. As most RCUK guidelines will be used in emergencies where efficient, timely action is
critical, they should include clear, succinct recommendations with easily understood
algorithms. Considerable care should be taken to ensure that the guidelines are written in
plain English and unambiguously; this includes review by non-medical individuals prior to
publication. The implementation of the guidelines in support of new evidence benefits
from multiple approaches. This can include updating training course curricula, manuals
and other materials by RCUK. Specifically:
a. Each section is clearly identifying the question being answered, with the key
recommendations highlighted (e.g. the BLS guidelines clearly state ‘Give 2 ventilation
breaths after every 30 chest compressions’).

RCUK Guidelines development process manual 13

 b. The certainty of the underlying evidence for any recommendation will be clearly
identified and articulated in the form of evidence to recommendation discussions.
c. (e.g. 2015 Advanced Life Support guidelines state - ‘A single precordial thump has a
very low success rate for cardioversion of a shockable rhythm. Its routine use is
therefore not recommended.’)
d. Recommendations will demonstrate analysis and discussion of the health benefits,
side effects and risks (e.g. to survival or quality of life).
e. Key priority recommendations will be emphasised, with targeted implementation,
including the use of algorithms.
f. Recommendations that an intervention ‘must’ or ‘must not’ be used are solely
included if there is a legal duty to apply this (e.g. adverse events that would be
supported by statutory regulation).
4. It is made clear if guidance is new or an update to previously published guidance. For
updated guidance previous versions should be referenced (e.g. the 2015 guidelines
documents clearly lists in the introduction which documents it is replacing).
5. The different options for management of the condition or options for intervention are
clearly presented (e.g. use of an automated external defibrillator is recommended for use
by all rescuers, whilst only those rescuers who are confident and experienced in
emergency interpretation of ECG rhythms can use manual defibrillators).
6. The purpose of the guidelines is to provide evidence-based interventions that are most
likely to be successful (e.g. increase the chances of successful resuscitation from cardiac
arrest with full neurological recovery). Equality issues should be integral to the
interpretation of evidence and translation of this into national clinical guidelines is
consideration of equality issues. See Appendix 6 for the Equality Impact Assessment
Tool used.
7. The date of search, the date of publication or last update and the proposed date for
review are clearly stated.
8. The content and style of the guidance is suitable for the specified target audience.
Members of the user groups should be involved in reviewing the final document. Use of
everyday language for patients, their family and carers, and the wider public.
9. RCUK guidance aims to be practical and user friendly. Detailed supporting evidence will
usually be linked or referenced, rather than included in the main text of any guidance.

RCUK Guidelines development process manual 14

4. Implementation
The working group will produce an implementation plan ensuring:
1. Stakeholders are aware there will be new CPR guidelines (e.g. all NHS). All NHS
bodies and voluntary groups with an interest in CPR were informed that new/updated
CPR guidelines would be published in 2021.
2. A timeline for implementation and sharing this with stakeholder groups is included
3. Any implementation issues such as resource and cost issues have been raised with
relevant stakeholders and individuals, and solutions identified to ensure there are no
delays in the release of updated training and implementation materials. For example,
the voluntary aid organisations (St John Ambulance, Red Cross, British Heart
Foundation), who run first aid courses, were informed of key changes to CPR
guidelines in advance of the final publication to enable them to update their teaching
materials in a timely and coordinated manner.
4. Implementation is assessed (e.g. RCUK has collaborated with the Intensive Care
National Audit & Research Centre to establish the National Cardiac Arrest Audit
(https://ncaa.icnarc.org/Home) for in-hospital cardiac arrest). It has also established an
Out-of-hospital cardiac arrest outcomes project in partnership with Warwick University,
the British Heart Foundation, and the Ambulance Service. These registries enable
RCUK to evaluate impact of the guidance and develop time series measurements
relating to patient outcome, epidemiology and trends in cardiac arrest.
5. The Communications Manager publicises guidance.
6. Free supporting tools are provided:
a. free access on RCUK website www.resus.org.uk
b. posters (e.g. algorithm posters freely available on RCUK website)
c. applications on web, and commonly available smart phones (iPhone, Android
devices) and tablet devices (e.g. www.life-saver.org.uk)
d. iResus app for algorithms
e. free videos on RCUK YouTube channel (e.g.
www.youtube.com/watch?v=jQYHQr3ebLo)
f. free video podcasts (e.g. www.youtube.com/watch?v=uuQERzOOzI8)
g. use of PowerPoint™ presentations (e.g. anaphylaxis)
h. social media on Facebook and https://en-
gb.facebook.com/ResuscitationCouncilUK and Twitter
https://twitter.com/resuscouncilUK
i. work with stakeholders to establish implementation tools (e.g. RCUK worked with
Save a Life Cymru on CPR animation (https://www.resus.org.uk/watch)).
7. Guideline updates are included on the programme for RCUK Annual Conference and
there is liaison with the stakeholder group to present updates at other national
meetings.
8. Where appropriate, teaching and relevant course materials are developed to support
new guidelines.
9. In addition, for its resuscitation guidelines, RCUK will develop updated teaching and
course materials. RCUK currently has over 16,500 volunteer instructors and each year
over 148,000 healthcare staff attend one or more of the following RCUK courses:
• Advanced Life Support (ALS) course
• European Paediatric Advanced Support (EPALS) course

RCUK Guidelines development process manual 15

 • Immediate Life Support (ILS) course
• Paediatric Immediate Life Support (PILS) course
• Newborn Life Support (NLS) course
• Generic Instructor course (GIC)
• Focused Echocardiography in Emergency Life support (FEEL) course
• Advanced Resuscitation of the Newborn Infant (ARNI) course.
All RCUK courses are quality assured, and taught and assessed by trained instructors.

5. Evaluation
Evaluation on the effectiveness of the guidance is collected by:
1. ensuring guidance includes RCUK contact information for feedback
2. developing a common frequently asked questions (FAQ) section with guidance if
necessary
3. collect feedback from stakeholders and its instructors
4. assessment of data from national registries and audits such as the National Cardiac
Arrest Audit
5. working with the National Reporting and Learning System to assess patient safety
incidents related to resuscitation.

6. Updating of guidance
1. RCUK guidelines are updated every 5 years in line with the release of ERC Guidelines.
The next update will be in 2021. See Appendix 5 for further details of this process.
2. Both RCUK and ERC guidelines are based on the ILCOR continuous evidence
evaluation process.
3. Since 2017, ILCOR have conducted annual reviews as part of the continuous process.
Updates to UK guidelines occur only if there is new evidence for an interim statement.
This is usually when a study shows a significant treatment benefit or harm (e.g. the
beneficial effects of therapeutic hypothermia were published in 2002 and ILCOR made
an advisory statement in early 2003).
4. Other RCUK guideline and standards will be reviewed at the review date which is usually
at 5 years, unless new information or new implementation issues arise, as for CPR
guidelines. Identification of new information or new issues should continue through the
working group members, stakeholders, and end users.
5. RCUK will reconvene a working group to review guidance when an update is due.
6. For RCUK guidelines the working group will be formed and base its decisions on the
ILCOR, CoSTR and ERC Guidelines process. See Appendix 5 for details.
7. For its other guidance the working group will revisit the scope of the original document,
through consultation with stakeholders, and a further systematic review will identify if
there is any new evidence. This may lead to revision of the whole or part of the previous
guidance. If the initial systematic review was produced by another organisation, and an
updated review is not available, RCUK will conduct its own systematic review.

RCUK Guidelines development process manual 16

8. Decisions to update a guideline must balance the need to reflect changes in the evidence
against the need for stability, because frequent changes to guideline recommendations
would make implementation difficult.

7. Editorial independence
1. RCUK is a charity. Its income is derived from training and education activity. It is
completely independent from any commercial organisation. It is solely responsible for the
content of the RCUK guidelines and standards.
2. RCUK guidance on COI is applied to all new development activity (see Appendix 2).
Specifically:
a. all working group members will need to complete a COI form before joining the
group
b. COI declarations of working group members will be shared with the rest of the
group at the beginning of every meeting, and updated if necessary
c. COI declarations will be tabled in the final document.
3. The COI guidance states a ‘member may still participate in discussions that relate to this
topic but should not be involved in decisions. In some circumstances, and at the
discretion of the Chair of the relevant committee, if there is a major COI for a given topic,
it may be appropriate to exclude that individual from the whole discussion. A COI will
expire after one year after the COI no longer exists. If the Council discovers that an
individual has a COI that has not been declared, this will be reviewed by the COI panel
(i.e. the Officers). Failure to declare an interest may result in expulsion of the individual
from his or her role(s) in the Council’.

RCUK Guidelines development process manual 17

Appendices
Appendix 1 - Organisational chart

www.resus.org.uk/_resources/assets/attachment/full/0/24917.pdf

RCUK Guidelines development process manual 18

Appendix 2 - Conflict of interest (COI) Policy
Conflict of Interest policy
Resuscitation Council UK [RCUK] is a Charitable Incorporated Organisation. As such, public
and professional trust in the integrity and independence of its scientific and decision-making
processes, and its adherence to high standards for the conduct of its charitable activities is
essential. RCUK recognises that those representing the Council (see below) may have
relationships, interests, and memberships that support and benefit the objects of RCUK.
However, there may be occasions when these relationships give rise to or give the
appearance of an actual or potential conflict of interest. To protect both RCUK and those
representing the organisation, this policy is designed to allow disclosure of any such
relationships. The aim of the policy is to ensure that actions taken by those representing the
organisation are in the best interest of the RCUK), thereby protecting RCUK and its
representatives from the appearance of bias or improper influence by individual personal or
business interests, family or close associates within RCUK.

Definition of Representatives of RCUK

This term is used to include, but not be limited to Trustees, members of the Executive
Committee, members of the Subcommittees, members of Working Groups set up by RCUK,
and other individuals appointed to represent RCUK.

The Conflict of Interest Policy

1. RCUK wishes to ensure that all those who contribute to its scientific, educational,
administrative and professional activities declare any activities that could potentially
influence their judgement or contribution. Any declaration should be within the time
period of 18 months prior to, or 18 months following the date of signature.
2. This policy is for use by those defined above as Representatives of RCUK.
3. A conflict of interest (COI) is defined as ‘any circumstance or set of circumstances that
creates or has the potential to create a risk that professional judgement or actions may or
will be influenced by the said circumstances’.
4. The following are conditions in which Representatives of RCUK must declare an interest
which may or have the potential to conflict with their responsibilities to RCUK:
a. Employment: All representatives should make a full declaration of their paid
employment. Details of salaries received are not required.
Any voluntary positions must also be declared for full transparency.
b. Associated intellectual or business relationships: All representatives should make
a full disclosure about paid or unpaid relationships with other organisations. In
addition, if representatives or close family have a business relationship with a
company that is directly related to the possible areas under discussion, this must
be declared.
c. All representatives should make a full disclosure about paid or unpaid
relationships with other organisations including other charities. In addition, if
representatives or close family have a business relationship with a company that
is directly related to the possible areas under discussion, this must be declared.
d. Boards or consultancies (paid or not), honoraria, payment for lectures received: if
you are a board member or consultant (paid or not paid), or if representatives
received an honorarium or were paid for one or more lectures, for an external

RCUK Guidelines development process manual 19

 party and directly related to the possible areas under discussion, these must be
declared.
e. Equity, shares, ownership: Equities, shares and ownerships by representatives or
immediate family1 if directly related to the possible areas under discussion, must
be declared. If you participate in an investment fund over which you have no
control how the fund is managed, this does not need to be declared.
f. Funding of research grant received: Regardless of the kind of funding (industry or
charitable), funding of research grants received must be declared.
g. Miscellaneous disclosures: Other relationships directly related to the possible
areas under discussion, which may be perceived by the public or colleagues to be
a COI (e.g. medicolegal practice).
Where applicable, only the source of the income and the nature of the COI are to be
disclosed; the amount of any payment or grant etc. is not required.

5. When should a COI be declared?

a. All of the individuals defined as Representatives of RCUK will have a COI
Declaration record established. All Representatives must update their COI
declaration annually, immediately when there is a new COI as defined in 4c, or
after being reminded by RCUK Office. Alternatively, COI declarations can be
submitted to RCUK Office for entry onto the record at any point during the year.
b. If the representative has no potential conflicts, this also must be declared.
c. Individual members are responsible for keeping their COI declaration up to date
and to amend their COI declaration in case of new potential COIs.
d. When an agenda point is discussed in official meetings of RCUK, where one of
the members present has a COI, this member should declare his COI before this
agenda point is discussed.
6. Consequences of a COI
Having declared a COI, a member may still participate in discussions that relate to this
topic but should not be involved in decision making. In some circumstances, it may be
appropriate to excuse that person from the whole discussion.
If it is noticed that an individual has a relevant COI that has not been declared, this will be
reviewed by the Trustees. Failure to declare an interest may result in the Representative
being asked to relinquish their role within RCUK.
7. Record of interests and their publication
RCUK will keep an electronic COI record for all representatives including the Definition
of Representatives. The COI record will be made available to the Trustees and CEO.

Note:
1
Someone's spouse, partner, civil partner, parents and grandparents, children and
grandchildren, brothers and sisters, mother in law and father in law, brothers in law and
sisters in law, daughters in law and sons in law. Adopted, half, and step members are also
included in immediate family.

RCUK Guidelines development process manual 20

January 2018
Declaration of Conflict of interest/medicolegal record

Contact details
Name
Email
Address
Telephone number(s)
Position(s) held within RCUK
Conflict of interest/medicolegal record
Subject Details Paid/unpaid

Employment

Associated intellectual or
business relationships

Boards or consultancies

Equity/shares/ownership

Research funding

Miscellaneous (including other

charities not listed above where
you hold positions)

RCUK Guidelines development process manual 21

Appendix 3 - House style guide

https://we.tl/t-FKGLZF5gaK

https://resus.sharepoint.com/:b:/g/image_library/EX4ZBhz9ih9KtImsON9N2cABEuF85RvHL
Tj18G0ze8sNEQ?e=t2MBt5

RCUK Guidelines development process manual 22

Appendix 4 - Statement of editorial independence

Resuscitation Council UK is a charity. Its income is derived mainly from life support courses.
It has no financial relationships with the industry and is completely independent from any
commercial organisation. The charity is solely responsible for the content of RCUK.

RCUK Guidelines development process manual 23

Appendix 5 - Step by step process for developing
Resuscitation Council UK resuscitation Guidelines

Guideline Development Process RCUK resuscitation Guidelines

RCUK Guidelines development process manual 24

1. The international process for guideline review and publication can be viewed here -
https://www.youtube.com/watch?v=X7l9cwLX6Ec
2. The International Liaison Committee on Resuscitation (ILCOR) establishes the scientific
evidence base that underpins the guidance and creates treatment recommendations.
The detailed process used by ILCOR for the 2015 Guidelines is published in the peer
reviewed literature and forms the basis of the previous RCUK Resuscitation Guidelines,
Guidelines Process Manual (2014).
3. ILCOR has a website for this process that includes tools and guides for all participants
involved in the evidence evaluation process.
4. ILCOR convenes its science task forces (ALS, BLS, PLS, NLS, first aid and Education,
Implementation and Teams (EIT)). Membership of these task forces is determined by
identification of expertise in the related area. The task forces are responsible for
generating the questions for all the systematic reviews. They are helped in this process
by national Resuscitation Councils from around the world (ILCOR has representation
from all regions of the world, see www.ilcor.org) and stakeholder groups.
5. The ILCOR website allows any individual to propose questions for evidence evaluation.
6. ILCOR works with Knowledge Synthesis Units, Expert Systematic Reviewers, members
of the GRADE working group, and Information Specialists, and content experts, and
enforces a strict COI process to ensure a rigorous evidence evaluation process.
7. Once there is a systematic review and if warranted a meta-analysis, the process for
drafting a consensus on science and treatment recommendations is based on GRADE
methods using an evidence to decision framework.
8. This process includes periods for stakeholder input and public comment (e.g.
https://costr.ilcor.org/).
9. The final ILCOR manuscript undergoes full peer review by up to 5 independent peer
reviewers for each section. The editorial staff of the journal Circulation handles this peer
review process independently from ILCOR.
10. Once CoSTR is created, it is disseminated to the five continents for context specific
translation by a collaborative of National Resuscitation Councils. The European
Resuscitation Council (ERC) uses these recommendations to develop the ERC
guidelines. The ERC Guidelines are written by members of the ERC ALS, BLS, PLS and
Education Working Groups.
11. Members of RCUK Executive, Guidelines Working Group (GPG) and RCUK guideline
authors sit on the ILCOR and ERC processes to ensure a smooth evidence translation
process and to ensure that the knowledge and experience of RCUK plays an active role
in these processes.
12. Thus, RCUK derives its guidelines by taking the ILCOR source statements that inform
ERC guidelines and then translates this evidence base into treatment and practice
recommendations that are relevant for UK clinical practice. Reasons for differences in
guidelines between countries are mainly due to differing availability of certain drugs and
also differences in how healthcare is delivered (e.g. doctor versus paramedic staffed
ambulance services). Where there is lack of consensus RCUK GPG uses a nominal
group method for decision-making, i.e. the available treatment options are discussed and
then ranked by the group. Conflicts between ILCOR and ERC guidance and that from UK
bodies (e.g. NICE) are avoided by ensuring any relevant UK guidance and the supporting
evidence for it is included in the ILCOR guidelines process. RCUK ensures its guidance

RCUK Guidelines development process manual 25

 is in accordance with NICE guidelines; furthermore, RCUK ensures it is a stakeholder for
relevant NICE guidance so that its views are taken into account.
13. Simultaneously with the ILCOR and ERC processes RCUK convenes its CPR Guidelines
Working Group. This will convene at least 18 months before new guidelines are
published. The Chair will be chosen from the Executive Committee and should be
involved in the ILCOR process.
14. RCUK Patient Advisors and Sudden Cardiac Arrest UK represent patients’ and family
views. ILCOR processes actively encourage patient groups through stakeholder
engagement, with opportunity to comment on systematic reviews and their clinical
interpretation once posted on the Internet. For RCUK CPR guidelines, patient/carer
representation is achieved through representation on the group and RCUK Executive
Committee. A sub-group of the Executive is responsible for supporting patient
participation and reviewing the terms of reference supporting their involvement to ensure
they have equity and a voice within RCUK. UK Patient Groups will be alerted to the
publication of the ILCOR consultation period to allow them the opportunity to feed into the
process at an early stage, and t RCUK has established audit trails in addressing and
responding to comments provided.
15. The final RCUK Guidelines are published at the same time as the ILCOR Consensus on
Science with Treatment Recommendations (CoSTR) and the ERC guidelines. The
ILCOR CoSTR and ERC guidelines are published in the journal Resuscitation.
Instructors, members, and stakeholder organisations are advised of this date.
16. The final guidelines are posted on RCUK website with free access. Within the document,
where applicable, live links to relevant evidence, references or documents are provided.
All RCUK instructors and members, and stakeholder organisations are notified by email,
and other means. The American and European guidelines are published in the journals
Circulation and Resuscitation respectively and are also available free of charge.
17. Release of the guidelines also includes planned press releases to both the medical and
lay press to ensure wide dissemination. Stakeholders are also provided with advance
copies of the guidance to enable implementation on the release date.

RCUK Guidelines development process manual 26

Appendix 6 - RCUK equality impact assessment tool
RCUK is committed to promoting equality, eliminating unlawful discrimination and actively
considering the implications of its guidance for human rights. It aims to comply fully with the
Equality Act (2010)

Yes/No Comments
1. Does the guidance affect one group
less or more favourably than another
on the basis of:
• Race
• Ethnic origins
(including gypsies and travellers)
• Nationality
• Gender
• Culture
• Religion or belief
• Sexual orientation including lesbian,
gay and bisexual people
• Age
• Disability – learning disabilities,
physical disability, sensory
impairment and mental health
problems
2. Is there any evidence that some groups
are affected differently?
3. If you have identified potential
discrimination, are any exceptions
valid, legal and/or justifiable?
4. Is the impact of the policy/guidance
likely to be negative?
5. If so, can the impact be avoided?
6. What alternatives are there to achieving
the policy/guidance without the
impact?
7. Can we reduce the impact by taking
different action?

RCUK Guidelines development process manual 27

Appendix 7 - Conflict of interest statements of
manual authors

Name Conflict of interest

Dr Jasmeet Soar Consultant in Anaesthetics & Intensive Care Medicine, Southmead

Hospital, North Bristol NHS Trust, Bristol - paid
Chair ALS subcommittee, Executive Committee, Member ILS and
Research Subcommittees.
Previous chair - working groups for standards, anaphylaxis, guidelines

Paid positions
Anaesthetic private practice - paid
Editor, Resuscitation - paid
Medicolegal work - paid
Clinical lead NAP7 (peri-operative cardiac arrest), Royal College of
Anaesthetists - North Bristol NHS Trust receives 1 PA

Represents RCUK on following:

OHCAO project at Warwick University – Chair Steering
Committee
Royal College of Anaesthetists CPD
Board
NCAA Steering committee member

In addition –
ILCOR - ALS Task Force Chair
ERC – ALS SEC Co-chair
ERC – Scientific Program Committee Chair for Congresses

Sue Hampshire Director of Clinical and Service Development – paid

In addition -
ERC - Governance Committee Vice-Chair
ERC - Congress Committee member
National Advisory Board, the Circuit – Co Chair

RCUK Guidelines development process manual 28

 Professor Consultant Neonatologist, James Cook University Hospital, South Tees
Jonathan Wyllie NHS FT – paid

RCUK positions
President – Paid one day per week
Member NLS Subcommittee

In addition
Vice chair ILCOR NLS Task Force
Member ERC NLS SEC
Chair Northern Paediatric Cardiology Network

Dr Andrew Lockey Consultant in Emergency Medicine, Calderdale & Huddersfield NHS

Trust, Halifax - paid
Associate Postgraduate Dean, Health Education England

RCUK positions
Vice President
Chair – Restart a Heart Subcommittee

In addition
Medical Advisor, First at Scene First Aid Company – Honorarium

Elizabeth Yeates Self-employed physio – paid

RCUK positions
CARe subcommittee member – member

Kevin Mackie Private training provider - Director KCM Training Ltd - Self-employed

RCUK positions
Lead Educator,
Executive Committee member
Chair Education Subcommittee
ARNI, CARe and ILS Subcommittee member,
GIC Education Group Co-Chair

In addition
Honorary lecturer - Keele University

RCUK Guidelines development process manual 29

Appendix 8 - Guidance for co-authorship,
endorsement and support of publications

Endorsement policy
Introduction
This policy document covers the arrangements for RCUK in its working and interacting with
for-profit organisations, companies and business (collectively referred to as ‘industry’), and
with not for-profit organisations (NPO) or individuals, in all activities related to:
• project/product development or research
• branded products
• projects/products initially developed by industry, not for-profit organisations or individuals
that further the aims of both the applicant wanting to work with RCUK
• education and training products.

In this policy, the different categories of the working relationships that RCUK may have with
industry/NPO/individuals (partnership or endorsement or statement of support) are defined
and the requirement for each of those categories (and accompanying RCUK action) is made
clear.
The processes involved in establishing and maintaining those relationships are made explicit,
so as to avoid difficulties arising through inappropriate relationships, and to ensure that the
relationships of endorsement or partnership or statement of support are in line with the stated
policies and aims of RCUK (www.resus.org.uk/about-us/).

Establishing a relationship with industry/NPO/an individual

An application by industry/NPO or an individual for endorsement or partnership or statement
of support with RCUK is made by completion of the proforma below.

The application will be reviewed and ratified by the Executive Committee and Trustees after
its assessment by the Senior Management Team (SMT) along with named subject matter
expert/s (SME). Any decisions will be reported at the next Executive Committee meeting and
formally minuted.

Legal requirements
Legal consultation may be required as part of the application, and all applicants should take
RCUK Corporate partnership policy into consideration when considering submission.
RCUK will always fully meet the requirements of the Charity Commission for England
and Wales.
RCUK will meet any other requirements including requirements for contracts, Service Level
Agreements (SLAs), Memoranda of Understanding (MOU) and HM Revenue and Customs
legislation. Each product/project will be assessed, and the correct lawful course of action will
be followed.

RCUK Guidelines development process manual 30

Data protection requirements
The application will be stored electronically within RCUK systems. Unsuccessful applications
will be deleted after six months. Successful applications will be stored for the duration of the
agreement and then deleted one year after the discontinuation of the agreement.

Relationship of members of RCUK to partnership, endorsement or statements

of support
All members of RCUK including staff, the Executive Committee and Board Trustees must
apply this policy each occasion that a relationship with industry/NPO or an individual is
considered.
Chairs of RCUK subcommittees and working groups must ensure that their subcommittees
and working groups adhere to this policy by declaration at each meeting and with any other
activities that they are engaged upon whilst acting on behalf of RCUK. Each committee and
group member must provide an annual updating of their COI as required within the COI
policy.

Equality
RCUK will not enter any relationship intended specifically to give one member of industry,
NPO or individual competitive advantage over another. Reference to a particular
product/service by generic or trade name in RCUK’s publications or information services
never, in itself, constitutes partnership, endorsement or acts as a statement of support for
that product or service. Within RCUK’s publications, this applies also to pictures of
products/service, including items of equipment.

Openness and transparency

RCUK will report collaborations and financial contributions received from industry, NPO and
individuals in its financial report and accounts, and within its annual report. Wherever RCUK
has received assistance from industry, be that financial or in kind, this will be stated on
publicity and any other materials associated with the particular project, service, activity or
education material, whether these be printed or digital or in some other format.

Independence and impartiality

Before seeking financial contributions from industry, RCUK will ensure it has a thorough
understanding of the other party through a due-diligence process. Where financial support is
offered, RCUK will seek to be clear about the company’s expectations, ensuring that these
are in line with RCUK’s charitable aims. RCUK name, logo or any of its materials may not be
used by industry without our written agreement and RCUK will retain editorial control over
any content that refers to the relationship.

Avoidance of conflict
RCUK reserves the right to be judicious about its collaboration with and support to external
bodies. RCUK has a policy not to have industry partnerships, relationships or match-funding
bids with organisations that are not aligned with RCUK’s aims (www.resus.org.uk/about-us/).

RCUK Guidelines development process manual 31

This includes, but is not limited to tobacco and alcohol companies, betting agencies,
weapons industry, or any company or organisation whose activities conflict with RCUK’s
mission statement (www.resus.org.uk/about-us/). RCUK expects all partner organisations to
be forthcoming about new relationships that may undermine or conflict with RCUK’s aims or
activities (www.resus.org.uk/about-us/).

Right to withdraw endorsement or support

RCUK reserves the right to withdraw endorsement or support should information become
available indicating that the product, project, publication, statement or involvement of the
other organisation is contrary to aims of RCUK. This decision will be made in consultation
with the Executive Committee and Trustees. Should this happen, all reference to RCUK must
be removed from the organisation’s website/literature or other promotional material with
immediate effect as its association with RCUK will have ceased.

RCUK Guidelines development process manual 32

1. Products and projects
Levels of engagement
RCUK will allocate differing categories of approval depending on increased
public/professional profile of the organisation and its level of engagement in the project or
product. These categories will determine how RCUK’s position is acknowledged and whether
RCUK logo may be used.

Approval category Level of engagement

Partnership RCUK has been involved from the outset, has influenced the project or
product development from the planning phase to completion and is
satisfied that the work on the project/product has been carried out properly
and completed as intended and agreed.
RCUK has had the opportunity to comment throughout the process and
recommend/discuss/agree changes.

A contract SLA or MOU would be expected to be in place.

RCUK would normally allow its logo to be used on any associated material
following discussion and agreement with the Executive Committee and
Trustees.

Endorsement RCUK was not involved at the outset but has influenced (or had ample
opportunity to influence) the progress of the project/product and is satisfied
that the work on the project/product has been carried out properly.

Contracts, SLA or MOU may or may not be in place.

RCUK would normally allow its logo to be used on any associated material
following discussion with and agreement of the Executive Committee and
Trustees.

Support The project/product was developed by another organisation but is in line

with RCUK aims.

RCUK would not usually allow its logo to be used on any associated
material, but the developer may state that the project/product or its use is
‘supported’ by RCUK.

Not supported RCUK is asked to support or assess a finished project/product but does
not agree with one or more of its scope, relevance, method or
recommendations.

The project/product is not supported by RCUK and its developer must not
state or imply otherwise or use RCUK logo on any associated materials.

RCUK Guidelines development process manual 33

Review
Any level of engagement by RCUK in a project or product involving one or more external
organisations or persons shall be reviewed annually and reported to the Executive
Committee and/or board of Trustees. A decision will be made to continue that engagement or
otherwise (if the work is ongoing) and the decision process will be documented. RCUK
reserves the right to terminate any contract/agreement/MOU if the relationship is seen to be
contrary to the aims of RCUK. When that arises, any reference to continued involvement of
RCUK, any mention of support or endorsement by RCUK, and any use of RCUK logo must
be withdrawn by the other party.

1. Publications and statements

Levels of engagement
RCUK will allocate differing categories of approval, depending on its level of engagement in
development of the publication or statement. These categories will determine how RCUK’s
position is acknowledged and whether RCUK logo may be used.

Approval category Level of engagement

Joint Authorship RCUK has been involved from the outset in development of the publication
(Co-authorship) or statement and is presented as co-author throughout the publication or
statement.

A contract, agreement or MOU will usually be in place.

RCUK has had the opportunity to comment on the final draft of the
document and recommend, discuss and agree changes.

The final document has been approved by RCUK Executive Committee

and that approval ratified by the Trustees. The publication or statement will
bear the RCUK logo.

Endorsement RCUK is asked to review and comment on a finished or near-finished

document and believes that the document is valuable and has no
significant reservations regarding its content or its likely impact.

Where there has been opportunity to influence, RCUK will endorse it and
allow the use of the RCUK logo.

Supported RCUK is asked to review a finished document but is given no opportunity

to influence or change it.

RCUK believes that the general principles are of value but may have
some reservations (e.g. about aspects of the scope or relevance of the

RCUK Guidelines development process manual 34

 document, or of the method used). Where RCUK has reservations, an
individual decision will be made by the Executive Committee and/or
Trustees as to whether those reservations are strong enough to warrant
the document being ‘not supported’ or to require acknowledgement of the
reservations in the document if it is to be supported.

RCUK would not usually allow its logo to be used on any associated
material, but the developer may state that the project/product or its use is
‘supported’ by RCUK.

Not supported RCUK is asked to review a finished document but does not agree with one
or more of its scope, relevance, method, conclusion or recommendations.

The document is not supported by RCUK and the document must not state
or imply otherwise.

Review
Any level of engagement by RCUK with a publication or statement involving one or more
external organisations or persons shall be reviewed annually by the senior management
team and the review’s conclusions reported to the Executive Committee and/or board of
Trustees. Whilst engagement cannot be withdrawn from a single publication, it may be that
further support for future documents is withheld if circumstances or the statements change
and RCUK does not agree with the subsequent wording.

January 2021

RCUK Guidelines development process manual 35

Application form
Partnership/endorsement/statement of support Policy

Name
Position within
organisation/company
Email
Telephone number
Contact address

Short summary of company/organisation aims and activity, including website

address

Proposal/request

Proposed length of relationship with RCUK (e.g. ongoing or for a specific project, therefore
time-limited)

Benefits for the applying organisation (including any potential financial gain or
increased profile arising from the proposal)

Potential benefits for RCUK as identified by company/organisation (including any

potential financial gain or increased profile arising from the proposal)

How will RCUK be informed about progress/development? Include outline plans for
review schedule where possible

RCUK Guidelines development process manual 36

Response from RCUK
Decision summary (including individual products included in the agreement)

Decision made by/ratified by

Level of agreement ☐partnership ☐endorsement ☐support ☐not supported
Use of RCUK logo ☐Yes ☐No
Use of logo on promotional ☐Yes ☐No
material/website.

If yes, list any limitations on

this.

Reasons for decision (in more detail)

What input has RCUK had to date in the development?

Review date

Subsequent information/update (e.g. withdrawal of endorsement, yearly review).

If unsuccessful, what was the process for informing the applicant?

How long will records be

kept?

RCUK Guidelines development process manual 37

Appendix 9 – References
2018 International Consensus on Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care Science With Treatment Recommendations Summary.
Soar J, Donnino MW, Maconochie I, Aickin R, Atkins DL, Andersen LW, Berg KM, Bingham
R, Böttiger BW, Callaway CW, Couper K, Couto TB, de Caen AR, Deakin CD, Drennan IR,
Guerguerian AM, Lavonas EJ, Meaney PA, Nadkarni VM, Neumar RW, Ng KC, Nicholson
TC, Nuthall GA, Ohshimo S, O'Neil BJ, Ong GY, Paiva EF, Parr MJ, Reis AG, Reynolds JC,
Ristagno G, Sandroni C, Schexnayder SM, Scholefield BR, Shimizu N, Tijssen JA, Van de
Voorde P, Wang TL, Welsford M, Hazinski MF, Nolan JP, Morley PT; ILCOR Collaborators.
Resuscitation. 2018 Dec;133:194-206. doi: 10.1016/j.resuscitation.2018.10.017.

Part 2: Evidence evaluation and management of conflicts of interest: 2015 International

Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science
with Treatment Recommendations.
Morley PT, Lang E, Aickin R, Billi JE, Eigel B, Ferrer JM, Finn JC, Gent LM, Griffin RE,
Hazinski MF, Maconochie IK, Montgomery WH, Morrison LJ, Nadkarni VM, Nikolaou NI,
Nolan JP, Perkins GD, Sayre MR, Travers AH, Wyllie J, Zideman DA.
Resuscitation. 2015 Oct;95:e33-41. doi: 10.1016/j.resuscitation.2015.07.040.

Part 1: Executive summary: 2015 International Consensus on Cardiopulmonary

Resuscitation and Emergency Cardiovascular Care Science with Treatment
Recommendations.
Nolan JP, Hazinski MF, Aickin R, Bhanji F, Billi JE, Callaway CW, Castren M, de Caen AR,
Ferrer JM, Finn JC, Gent LM, Griffin RE, Iverson S, Lang E, Lim SH, Maconochie IK,
Montgomery WH, Morley PT, Nadkarni VM, Neumar RW, Nikolaou NI, Perkins GD, Perlman
JM, Singletary EM, Soar J, Travers AH, Welsford M, Wyllie J, Zideman DA.
Resuscitation. 2015 Oct;95:e1-31. doi: 10.1016/j.resuscitation.2015.07.039.

RCUK Guidelines development process manual 38