ABSTRACT
"Working for Patients" saw the start of a major NHS initiative. It stated that all doctors should become involved in audit. When the Medical Audit programme began in 1989 with "Working for Patients", there was no mention of Clinical Effectiveness (CE)— at that time it wasn't specifically on the Government's agenda. In discussing the history of CE in the UK, Cape describes "Promoting Clinical Effectiveness" as a more balanced document, considering the balance of cost versus CE. This chapter outlines CE as a population based approach to quality improvement. The National Institute for Clinical Excellence (NICE) is a special health authority, set up in April 1999, with new legislation developed in consultation with professional bodies. It is responsible for collating all the disparate material that exists in evidence based health care publications. National Service Frameworks (NSF) lay down the models of treatment and care to which people are entitled regardless of geographical location.
