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The Path.Finder NHS consortium consists of ten acute hospitals sharing a common approach to the production and dissemination of local information for primary care, including clinical practice guidelines. Ten local guidelines were studied across four clinical areas: dyspepsia, lipids, eczema, and menorrhagia. Local guideline developers largely appear to be unconvinced that investment of time and resources in “proper” guideline development is cost‐effective. At the same time, primary care professionals’ views about future NICE guidelines may have been coloured by their current much more variable experience. Successful implementation of local guidelines is unlikely to be straightforward.

Reports on a study which explored the views of key stakeholders regarding the meaning and implementation of effective health care and clinical governance in NHS Trusts, and the role for public health professionals. The authors used a national questionnaire survey to derive a sample for qualitative telephone interviews and two area case studies. The authors found that the meaning of effective health care and the means employed for implementation varied. Mergers were seen as hindrances to gaining organisational engagement whilst others, such as the White Paper on quality and the notion of clinical governance, were seen as facilitating. A widespread aspiration was a more integrated and corporate quality culture where quality was central, not marginal. The authors conclude that there is widespread concern among Trusts to change their culture and assert effective health care as a central value. Public health skills, rather than the discipline itself, are seen as important for such culture change.

Representatives of five prominent library integrated system vendors—M.E.L. Jacob (OCLC), Joe Matthews (Inlex), Mike Monahan (Geac), Gene Robinson (CLSI), and Steve Salmon (Carlyle)—express their views on ethics and the marketplace. The need for ethical behavior by all sectors of the marketplace—librarians, consultants, and vendors—is emphasized and illustrated. Four sidebars are included: one addresses the need for customer data rights standards; others contain the code of ethics/practice issued by three professional organizations for consultants.

Management training at Lloyds TSB Independent Financial Advisers has helped to boost enthusiasm among line managers, improve communication between departments and create a new momentum within the organization. The bank sought to provide managers and aspiring managers in its Independent Financial Advisers business with the skills, confidence and enthusiasm to operate with flair in a highly‐regulated marketplace. It opted for the Open University Business School (OUBS) professional certificate in management, combined with activities to enrich the curriculum and apply it to Lloyds TSB.

Waiting for the Coldstream Committee to finish tinkering about with the structure of the Dip AD (Diploma of Art and Design) and report, is something of an irrelevance in the present situation. This is not to say that their recommendations will be unimportant. The likely innovations, in terms of allowing greater degrees of specialization and the inclusion of ‘vocational’ diploma qualifications, will add considerable flexibility to the system, and there are other important issues which need to be pronounced upon — notably the GCE entrance qualifications, the absorption of the foundation year, and the democratic structures within the colleges. But the battles which will determine the future and status of art education are being fought elsewhere — if they are being fought at all.

The benefits of the thin film multichip module (MCM‐D) approach to high density packaging for VLSI devices have now been amply demonstrated by a number of research groups. The successful emergence of a viable multichip module industry from this research base will, however, depend upon the installation of an industry‐wide manufacturing infrastructure. This will have to provide the necessary range of concurrent design capabilities, make pretested bare die available, and include multichip module vendors who can offer an integrated capability in module design, substrate layout and manufacture, advanced module assembly, packaging and test. Each of these areas of MCM‐D technology merits detailed attention in its own right, sufficient to justify many individual papers and presentations. This present paper focuses on just one of these topics and addresses the approach taken by GEC Plessey Semiconductors (GPS) to the development and control of a highly manufacturable MCM‐D silicon substrate process. The GPS ‘Process I’ four‐layer metal, aluminium‐polyimide substrate technology is described, the technology development and process control test structures are detailed and process characterisation data presented.

Reports exploratory research into the reasons why many junior doctors are critical of medical audit; the extent to which consultants are aware of juniors′ views; and what might be done to make audit more acceptable to juniors – using structured interviews amongst staff (28 consultants and 34 juniors) in four district general hospitals in South‐East England. Junior doctors were critical of audit for five main reasons: the additional work involved; the audit cycle being longer than their job contracts; the topics reflecting their consultants′ interests and not theirs; doubt about the effectiveness of audit; and audit meetings being boring, intimidating and even incriminatory. Some consultants were well aware of these problems, but others were not. To increase the support of juniors, audit needs to: involve them more and be more participatory; be organized better; be less of a trial and more supportive; recognize the extra demands on juniors′ time. Offers suggestions for the successful implementation of medical audit.