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Two series of visits to practices in a district in north west England were undertaken to encourage significant event review. The first was to non‐participants in audit projects who discussed lumbar‐sacral spine X‐rays and deaths with the GP facilitator. The second was to single‐handed GPs who discussed new diagnoses. Levels of participation and completion were high and there was a significant fall in the number of X‐rays requested compared with neighbouring controls. This method of influencing professional performance is compared with others. An evaluation questionnaire suggested that the method was acceptable and useful. It is suggested that academic detailing/practice visiting has a vital place in developing clinical governance in primary care, especially in recruiting those who have seldom been involved in audit activities in the past.

This series of papers aims to explore the transition from higher education into work. It reports on research undertaken over a period of two years and which sought to track a number of young graduates as they completed their studies and embarked upon career of choice.

The approach adopted is defined and discussed as one of “common sense”. Alongside the notion of “common sense” the paper deploys two further concepts, “convention” and “faith” necessary to complete a rudimentary methodological framework. The narratives which are at the heart of the papers are built in such a way as to contain not only the most significant substantive issues raised by the graduates themselves but also the tone of voice specific to each.

Five cases are presented; the stories of five of the graduates over the course of one year. Story lines that speak of learning about the job, learning about the organisation and learning about self are identified. An uneven journey into a workplace community is evident. “Fragmentation” and “cohesion” are the constructs developed to reflect the conflicting dynamics that formed the lived experience of the transitional journeys experienced by each graduate.

Whilst the longitudinal perspective adopted overcomes some of the major difficulties inherent in studies which simply use “snap shot” data, the natural limits of the “common sense” approach restrict theoretical development. Practically speaking, however, the papers identify issues for reflection for those within higher education and the workplace concerned with developing practical interventions in the areas of graduate employability, reflective practice and initial/continuous professional development.

The series of papers offers an alternative to orthodox studies within the broader context of graduate skills and graduate employment. The papers set this debate in a more illuminating context.

A district‐wide audit was completed for five different aspects of the care of patients with epilepsy: principally issues for women of child‐bearing age and the offer of annual reviews to patients, possibly conducted by questionnaire. There were improvements in care but less than half the original participants completed the audit, perhaps because it was over‐complicated. Review by questionnaire seemed acceptable to many patients. The authors believe this is the largest audit cycle of this subject in general practice. Although the numbers of people with epilepsy is not large, the care of these patients is easily overlooked. The project has several lessons for all those introducing and developing clinical governance.

Background: Many audits in primary care can be criticized because of the absence of verifiable data to measure outcomes, and the lack of a non‐participating group against which to compare results. Objective: Using Prescribing Analyses and Cost (PACT) data to quantify the effect of an audit in 15 practices. We sought to quantify the effect of the audit of benzodiazepine prescribing in a district by measuring the detailed changes in prescribing in participating practices before, during and after audit, and by comparing the volume of prescribing of these drugs in participating and neighbouring non‐participating practices. Methods: At the start of the audit, 291 993 patients in the Sefton district of North West England were registered with 55 general practices. Fifteen practices, caring for 87 902 patients, took part in an audit of benzodiazepine prescribing. We analysed routinely‐collected prescribing data to assess trends in benzodiazepine prescribing for those practices which took part in the audit and the remaining (non‐participatory) practices in the district. Main measures: The number of defined daily doses of benzodiazepine prescribed by those general practitioners auditing their prescribing of these drugs during the audit. The volume of benzodiazepines prescribed by all general practitioners in Sefton during the quarter immediately before and the quarter immediately after the audit. Results: There was a significant reduction in the number of defined daily doses dispensed for temazepam, nitrazepam, and lorazepam during the audit. There was a significantly greater reduction in the number of items prescribed by those doctors who took part in the audit than their colleagues who did not. Conclusions: An audit of benzodiazepine prescribing achieved a significant reduction in the volume of these drugs dispensed. An analysis of routinely‐collected data can usefully measure the result of an audit of prescribing.

Schools and school systems around the world are being challenged to emulate management practices used in business organizations. Reports on a case study of management in a computing firm in Sydney, Australia. Attention focuses on communication, the methodology of work, characteristics of the organizational setting, organization structure, selection and motivation of staff, goals of managers and management styles. The findings provide a basis for discussing the relevance of business management practices for education. Managers in education and private enterprise may have much to gain from one another. However, each sector also has distinctive attributes which make transfer of some practices inappropriate. Concludes by considering the benefits for educational managers of observing business executives in action.

Analyses and checks the annual forecasts produced each autumn from four prominent UK economic modelling organizations. Compares these forecasts with those of three Bayesian vector‐autoregressive models. Examines the accuracy for each set of forecasts up to four years ahead and for different horizons. Examines the direction of the forecasts and the effect of forming simple combinations of the different forecasts. Finds evidence that while the BVAR forecasts are inferior to those from the economic models, they contain information which could be used in order to improve the other forecasts.

An innovative programme to teach postgraduate students studying for a Diploma in Personnel Management the skills of creating computer‐based training material is described. Key features of the adopted teaching/learning strategy are illustrated and issues and implications which have emerged thus far are highlighted. The case for inclusion in the teaching programme, the authors believe, does not rest solely on the assumption that personnel and training officers will increasingly require skills of designing a computer‐based training material. Assessed learning outcomes together with an evaluation of student views suggest a value to the teaching programme over and above the specifically stated objectives.

Examines the present strengths and weaknesses of the general practice system. Proposes a different structure for the future which should provide benefits for both the purchasers and providers of health care, as well as for the patients themselves.

The purpose of this article is to review all patients having received a steroid injection for rheumatic problems in the period 1995‐2003 by one general practitioner.

Self‐completion questionnaire given to patients at the time of the injection to be returned after one month.

Most of the 435 patients (92 per cent) were pleased that they had received the injection. Pain was relieved better than mobility. Results for different sites were similar. Complication rates were low and many patients had further steroid injections.

It is feasible to collect large series reviewing the outcome of interventions in general practice. Results can be usefully compared with those obtained in randomised controlled trials.

This is the largest review of steroid injections carried out in a single general practice in the UK. It provides information with which others can compare their own practice and results, especially in primary care.