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The purpose of this study is to analyse the effect on clinical practice of auditing doctors, advanced nurse practitioners and pharmacist consultations within an out of hours primary care organisation and the resultant effects this may have on clinical practice and the quality of care provision.

The study utilises a multi method time series case study approach using the results from the Royal College of General Practitioners (RCGP) audit tool analysis, alongside focus group analysis and participant observation.

The results demonstrate that there is a clear link between implementation of a clinical audit strategy within a wider clinical governance framework and improved standards of all clinician's work. This study also demonstrates how the analysis can inform a definition of quality.

The definition of quality is limited and is one of the limitations of the study since it is related to out of hours primary care only.

Results may be extrapolated to other care providers both out of hours and in traditional GP practices.

This case study demonstrates how the time series analysis of audit results can assist in assuring commissioners of health services of the quality of the services they appoint.

This article summarises research that explored the way that policy has worked in UK mental health services over the last 20 years. It constructs a framework for analysing three stages of policy making, namely: policy initiation, policy formulation and policy implementation. Three levels of policy activity are also identified; these are located at the macro, national, level; the meso, district health authority level; and the micro, provider level. A matrix is then built up that facilitates an exploration of policy activity within and between these stages and levels. The main findings of the study were that, historically, no level has held a monopoly on power or influence in the policy process, that the hitherto unsung role of the meso level has been crucial for policy success and that managers’ abilities to shape their organisation decline above the meso level. Since the Labour Government came to power in 1997, however, the macro level has begun to dominate the policy process. The ensuing “top down” approach to policy formulation is encouraging uniformity of service, but may be stifling creativity. Policy activity is becoming less than the sum of its parts.

SINCE I have spent the better part of fifteen years parading in the public arena the superiority which attaches to me by reason of not possessing a television set, I had better now come clean and reveal that immediately before Christmas my wife and I changed our minds and rented one for a trial period of six months.

Sport events have become an important component of many city marketing plans. Media coverage is believed to increase awareness of the host city. This study reports the results of a content analysis of 2002 NCAA Women's Final Four telecasts. Event logos provide the most exposure for the host city, with little obtained via city images. Icons were found to effectively differentiate the city from competitors. Practical implications and future research extensions are suggested.

THE relinquishing of the Presidency of the Library Association by Dr. Arundell Esdaile must of course receive the attention it deserves. This will probably be when the new President, Mr. Cashmore, is inducted into the office at Birmingham—an event which we understand will take place early in February.