UpToDate vs BMJ Best Practice (2025): Deep Specialist Evidence vs NHS Workflow

Last reviewed: 2025-12-17 · Reviewed by

At a Glance

Who is it for?

UpToDate:Specialists / Hospital Medics

BMJ Best Practice:Junior Doctors / Generalists

Why choose UpToDate?

  • Unrivalled depth for complex/rare conditions
  • Extensive drug interaction checker (Lexicomp)
  • Global 'Gold Standard' for evidence synthesis

Why choose BMJ Best Practice?

  • Free for all NHS staff (OpenAthens)
  • Step-by-step 'Patient Journey' flowcharts
  • Includes 'Comorbidities' management tool

Feature Comparison

CapabilityUpToDateBMJ Best Practice
PricingExpensive subscription (or Trust-wide)Free for all NHS staff (funded)
AccessDesktop & App (requires login)Desktop, App & integrated into EHRs
Primary StrengthDepth of detail & rare diseasesActionable, concise management plans
Content FocusPathophysiology & comprehensive evidenceDiagnosis & step-by-step treatment
Guideline BasisInternational/US dominantUK/International (accredited by NICE)

In-Depth Analysis

Overview

UpToDate is the academic heavyweight. It is written by world-renowned experts and functions as a constantly updated digital textbook. It is the go-to resource when you need to understand the nuance of a condition or manage a complex, multi-system patient where standard guidelines don't apply.

BMJ Best Practice is the practical pragmatist. Funded by Health Education England for all NHS staff, it is designed for the point of care. Its content is structured around the patient journey (Diagnosis -> History -> Management), using unique "treatment algorithm" flowcharts that make it incredibly fast to use during a busy ward round or clinic.

Key Differences

The primary differentiator is depth vs. speed. If you have a patient with an undifferentiated presentation or a rare syndrome, UpToDate is indispensable. However, for the majority of core NHS work—admitting common presentations, verifying first-line treatments, or checking UK-specific guidelines—BMJ Best Practice is often faster and better aligned with UK formulary choices.

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Use-Cases

Complex Hospital Medicine

When to choose UpToDate

  • Essential for managing complex patients with rare conditions or complications.

When to choose BMJ Best Practice

  • Good for initial workup, but may lack the granular detail needed for sub-specialty decisions.

On-Call Night Shift

When to choose UpToDate

  • Can be text-heavy when you need a quick answer.

When to choose BMJ Best Practice

  • Excellent. The 'Acute' flowcharts provide a checklist-style guide for emergencies.