Promoting clinical effectiveness

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7045.1491 (Published 15 June 1996) Cite this as: BMJ 1996;312:1491
  1. John Hayward
  1. Adviser in public health and primary care North Camden Division, Camden and Islington Health Authority, London NW1 2LJ

    A welcome initiative, but both clinical and health policy need to be based on evidence

    Britain's NHS Executive seems determined to encourage an evidence based and evaluative approach to clinical decision making. Earlier this year it issued a booklet, Promoting Clinical Effectiveness—A Framework for Action in and through the NHS, to chief executives of health authorities and NHS trusts.1 This is a useful and important document, but many health professionals may think that the promotion of effective clinical policy would be even more welcome if it were matched by an evidence based culture in other areas of government health policy.

    Promoting Clinical Effectiveness has a tone very different from earlier approaches of the executive. Two years ago purchasers were urged to put the use of clinical guidelines into contracts.2 This was advocated as a mechanism that could promote good practice, but it was untried and at best a blunt instrument: some guidelines were not even based on good evidence, to the embarrassment of those expected to work with them. In contrast, this recent publication is designed to be supportive, not prescriptive, and that in itself is a welcome change.

    The booklet provides excellent background reading for anyone seeking a guide to the subject. It summarises the value of systematic reviews, publicises the work of …

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