Northampton General Hospital NHS Trust was involved in the development of Healthcare Resource Groups (HRGs) from their inception and has used the expertise developed locally to put them to practical use throughout many areas of trust management at clinical department level. Internally to compare the relative performance of different clinical services, and externally to compare the performance of clinical services within the trust against those of similar organizations. The development of clinical resource profiles enabled clinical staff to specify the resources required for any one particular HRG and gave them the major input into the costing of clinical services. Using the national hospital episodes statistics (HES) data as a benchmark, the current clinical performance and relative efficiency of a large number of clinical specialties were assessed. Concurrent with the clinical audit programme a pilot OutReach scheme was introduced for patients undergoing hip replacement.