ABSTRACT
General practitioners (GPs) could essentially abandon all responsibility for the management of cardiovascular diseases to the specialist 'expert' if they so wished, for several reasons –both professional and scientific. The major advances in cardiovascular disease prevention and management, which younger clinicians take for granted, have occurred in the last 25 years. As there was no agreement on how to administer optimal cardiac care, the quality of and waiting times for services varied widely between hospitals just a few miles apart, depending on local 'expert' advice and management competence. Guidelines have become an integral part of all areas of clinical practice and the management mindset of clinicians in Europe and the USA. Audit is a difficult discipline but it helps clinicians think about how they can improve their clinical practice and service, and provides objective information to help justify changes. The National Service Framework (NSF) documents changed our world dramatically.
