Table A

Table A Some sources of information on cost effective interventions

� Abstracts of reviews from the Cochrane Library (including databases of systematic reviews and reviews of effectiveness) are available on www.update-software.com/ccweb/cochrane/cdsr.htm; for the full text of reviews it is necessary to subscribe to the Cochrane Library

� The "Netting the Evidence" website of the University of Sheffield School of Health and Related Research (www.shef.ac.uk/~scharr/ir/netting.html) has a comprehensive list of websites with sources of evidence, some of which is relevant to primary care

� Effective Health Care Bulletins are available on www.york.ac.uk/inst/crd/ at the National Health Service Center for Reviews and Dissemination

� Bandolier is a newsletter to support evidence based practice. It is available on www.jr2.ox.ac.uk/Bandolier/

� The Centre for Evidence Based Medicine in Oxford (cebm.jr2.ox.ac.uk/) lists some critical appraisal topics relevant to primary care (163.1.212.5/cats/allcats.html). The centre also runs courses to help make sense of information on cost-effective interventions (cebm.jr2.ox.ac.uk/docs/calendar.html).

� Prodigy software, a computerised clinical decision support system, is available free of charge on 85% of UK computer systems (www.schin.ncl.ac.uk/prodigy/). Prodigy can offer advice during consultations on what to do in over 150 conditions commonly found in primary care

� Clinical Evidence is a six monthly, updated compendium of evidence on the effects of common clinical interventions, published by the BMJ Publishing Group (www.evidence.org/index-welcome.htm)

� WAX is an electronic knowledge management tool developed in Cambridge and designed for use by doctors and other primary healthcare staff (http://www.waxinfo.com/).

� The Doctors Desk (drsdesk.sghms.ac.uk/) is an integrated desktop information and communications system for general practice being field tested through South Thames Region�s research network. It aims to provide general practitioners with a convenient source of evidence based medicine and guidelines.

� The National Institute for Clinical Excellence (www.nice.org.uk/) produces information about clinical effectiveness and cost effectiveness

� The Department of Health�s national research register (www.update-software.com/National/nrr-frame.html) contains details of over 53 000 ongoing and recently completed research projects funded by, or of interest to, Britain�s NHS

� The US Agency for Health Care Policy and Research (text.nlm.nih.gov/) has guidelines on many topics relevant to primary care

Journals

� The BMJ is available on bmj.com/all.shtml and has a search facility. Guidelines on topics such as angina and heart failure are on the journal�s website (at bmj.com/cgi/content/full/316/7140/1303 and bmj.com/cgi/content/full/316/7141/1369 respectively)

� The bimonthly Evidence-Based Medicine provides summarised "value-added" abstracts and commentaries by clinical experts on a wide range of recent papers in other journals. Most of the summaries are on therapeutic interventions and only some are relevant to primary care.

� A list of the contents of the British Journal of General Practice and some of the editorials are available on www.rcgp.org.uk/

� The Lancet is available on www.thelancet.com/ with limited access to non-subscribers

Bulletins and journals sent to all general practitioners in the United Kingdom

� The fortnightly Drug and Therapeutic Bulletin is commissioned and researched by the Association for Consumer Research. A teams of "impartial editors" aims to provide the "best available advice on treatment." (For details on how articles are produced see Drug and Therapeutic Bulletin 1997; 35:73-4 or their website, www.which.net/health/dtb/main.html)

� The Prescribers� Journal is compiled by a "representative committee of management supported by an advisory panel." Articles are commissioned and peer reviewed. The journal is published quarterly

� The Medicines Resources (MeReC) Bulletin is the main output of the National Prescribing Centre in Liverpool. This monthly bulletin focuses "directly on the information needs of GPs" and aims to facilitate high quality, cost effective prescribing

Table B Some documents highlighting national and local priorities relevant to primary care

� The 1999 national service framework for mental health can be found on www.doh.gov.uk/nsf/mhexecsum.htm and the 2000 framework for cardiovascular disease on www.doh.gov.uk/nsf/coronary.htm

� The 1998 national framework for assessing performance (www.doh.gov.uk/nhsexec/nhspaf.htm) gives details of the system for assessing quality of performance in NHS across six areas: health improvement; fair access; effective delivery of appropriate healthcare; patient and carer experience; health outcomes of NHS care; and efficiency

� The 1999 white paper Saving Lives: Our Healthier Nation sets out an action plan to tackle poor health. A summary is available at www.doh.gov.uk/ohn.htm

� The 1998 Independent Inquiry into Inequalities in Health can be found on www.official-documents.co.uk/document/doh/ih/ih.htm

� The world wide web has numerous examples of Health Improvement Programmes (HimPs) developed by health authorities�for example, www.suffolkcc.gov.uk/health/ and www.dorset.swest.nhs.uk/himpintro.html

Table C Some resources to help primary care groups and trusts develop clinical governance

� The Royal College of General Practitioners has produced Clinical governance: practical advice for primary care in England and Wales and has set up a unit to offer advice and support for practitioners implementing clinical governance and creating linkages between practising general practitioners, educators, and researchers in developing testing and refining systems of clinical governance (www.rcgp.org.uk/)

� The National Primary Care Research and Development Centre published Quality Assessment for General Practice; supporting clinical governance in primary care groups, which gives details of a number of other internet and paper resources to support clinical governance. It is available on www.npcrdc.man.ac.uk/

� A site based at the North Thames regional office (www.open.gov.uk/doh/ntro/cgov.htm) is designed to support clinical governance

� Information on all primary care groups is available on an NHS Executive primary care database at tap.ccta.gov.uk/doh/pc2ext.nsf

Table D Sources of information on clinical audit and effectiveness

· Information on audit protocols is available from the Clinical Governance Research and Development Unit on www.le.ac.uk/cgrdu/

· Some medical audit advisory groups have published their own audit packages or the results of audits. These include those in Suffolk (www.suffolk-maag.ac.uk/disease/index.html) and north Essex (www.equip.ac.uk/).

· CONQUEST is a comprehensive index of review criteria for clinical conditions developed by the Harvard School of Public Health; it is available on www.ahcpr.gov/qual/conquest.htm.

· CHAIN (Contacts, Help, Advice and Information Network) is a database designed to facilitate links between healthcare professionals and others interested in evidence based health care and clinical effectiveness. It provides a network for exchanging information and views on clinical effectiveness. It is available on www.doh.gov.uk/ntrd/chain/chain.htm