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Discusses the role of top management in providing leadership by example on the road to Total Quality. Explores important themes from executive workshops ‐ how to “model” quality and service in all interactions with employees; how to market the quality and service precept; and how to be visibly involved in the continuous improvement programme. Reviews customer research, training and follow through procedures. Suggests that the completion period of the programme must be overseen by a steering group of key players in the business who will be given specific responsibilities.

Our regular contributor on the contemporary educational literary scene reviews a mixed bag of practical books.

Describes how Joshua Tetley′s “Quality Pays” programme illustrates that the only way to achieve a real, sustainable competitive edge, is to commit the company to a service‐driven organisation. Traces the development of the Quality Pays programme and the need to develop an infrastructure to facilitate Quality Pays as an on‐going process. Describes the programmes basic aims and the training involved. Lists six key ingredients which enable companies to maintain the momentum and avoid some of the pitfalls of earlier quality service initiatives. Asserts that following these six ingredients should enable companies to develop a culture based on the premise that the customer is always right.

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.