Methods for producing a National Infection Prevention and Control Manual in Scotland: 2025 update with a new considered judgement form.

INTRODUCTION: The National Infection Prevention and Control Manual (NIPCM) is an online evidence-based resource developed by Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland (NHS Scotland). Following a 2022 evaluation and informed by lessons from the COVID-19 pandemic, the NIPCM guidance development process was reviewed to improve transparency and support auditable decision-making. METHODS: The guidance development methodology, inclusive of the recommendation grading system, was assessed as part of an annual review process. Extant infection prevention and control (IPC) or public health guidance development frameworks of relevance were identified and appraised for potential integration into a new considered judgement form (CJF), which was piloted in practice with working groups. RESULTS: Elements from the SIGN 50 and HICPAC methodologies were incorporated into ARHAI Scotland's new CJF with notable addition of a dedicated 'Expert opinion' section. The recommendation grading system was altered from a lettered system (A-C) to use of the terms 'recommendation' and 'good practice point'. CONCLUSION: By clearly documenting decision making, context and expert opinion, the new CJF improves transparency and supports guidance users with interpretation and implementation. The new grading system more adequately conveys the strength of supportive evidence and practical intent of recommendations.