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In April 1999, 481 English Primary Care Groups (PCGs) were created. The National Primary Care Research and Development Centre is leading a three year longitudinal study, in conjunction with the King’s Fund, to track the development of PCGs. The implementation of clinical governance is an important responsibility of PCGs. This survey aimed to describe initial progress in implementing clinical governance in primary care, and to describe barriers to change. Data were collected in autumn 1999, using a questionnaire to clinical governance leads, in a random sample of 72 PCGs. PCGs have put considerable effort into the development of clinical governance and an extensive range of activities were planned for tracking quality of care. However, PCGs face barriers in implementing clinical governance and they must foster a culture of engaged participation by practices and practice staff. PCGs must also be given the time and resources needed to implement clinical governance.

Investigates the provision, dissemination and use of community information in public libraries in five different social areas by means of interviews with community librarians and library users. Reveals that information from the Department of Social Security was the most heavily used. followed by bus timetables. People in the more affluent areas tended to make more use of community information than those in the poorer areas. The information could perhaps be more effectively promoted and more outside groups could be encouraged to use the libraries.

Following the Gulf War, international discussions took place about multilateral restraints on “destabilising arms transfers”. Given that the UK is one of the leading exporters of arms, any reduction in such exports would affect the UK economy. The UK government spends considerable sums promoting such exports and it benefits from defence exports as they reduce the Ministry of Defence’s procurement costs. This paper analyses the direct financial implications of arms exports to the UK government, both as a buyer of defence equipment and as a promoter of such exports. The results suggest that in the UK each job generated by arms exports is subsidised by just under £2,000 per annum and that a one‐third reduction in UK defence exports would save the taxpayer some £76 million per annum (at 1995 prices).

The purpose of this trial was to establish whether a change in the X‐ray referral procedure would reduce the time between presentation and admission for patients who attended a busy Accident and Emergency department with a fractured neck of femur. This group of patients was selected because they are susceptible to decubitus ulcers, the development of which may relate to the time spent on a trolley. Senior nurses in the Accident and Emergency department were educated in patient assessment and management, and knowledge and implementation of ionising radiation regulations. They then referred patients who presented with suspected fractures of the femoral neck to the radiology department within agreed guidelines and without a doctor's examination. Records were kept over a 3‐month trial period. A total of 27 completed cases were recorded and the data included radiological findings, total time from presentation to arrival on the ward or discharge, total time waiting for a porter and being transported, total time spent in the radiology department, and whether the patient reattended for a further X‐ray examination. We concluded that the change in X‐ray referral procedure resulted in an appreciable reduction in the overall time between presentation and admission. However, it was not possible to draw any valid conclusions regarding any reduction in decubitus ulceration as a result of this speedier diagnosis and admission.

Information technology has made possible the recognition, acquisition, organization, and controlled retention of data from sources virtually unavailable in the past. Terms such as “the information society” and “information glut” have become commonplace. High‐level corporate positions with titles such as Chief Information Officer are being created in an attempt to efficiently and effectively use information for the benefit of the organization and the society it serves. A major challenge in the 1980s is to gain and maintain the ability to use this information for competitive advantage. Decision Support Systems (DSS) enable marketing managers to integrate internal and external information environments within a decision‐making context. Useful features available within Marketing Information Systems can be incorporated with the potentials of DSS. Together the two systems can provide marketing managers with opportunities to anticipate, identify, and creatively respond to changing consumer demand.

Although the Cold War is over, the dangers of international armed conflict remain. Multinational talks about restricting the arms trade stalled in 1992. If they resume, what should the British attitude be towards participation in a multilateral agreement to limit arms exports when such exports apparently make a significant contribution to the UK economy? Sensible public debates and choices need information on the likely economic impacts of alternative scenarios. This paper examines the likely effects of a one‐third reduction in the value of UK arms exports. It finds that between 13,333 and 40,000 jobs would be lost and that of those that remain in the labour force over half will find new work within a year. The South‐West would be the worst affected region losing 0.3 per cent of all jobs; defence sales would be cut by between 3 and 8 per cent; aerospace output would be cut by between 5 and 9 per cent , and total exports would fall by 0.5 per cent. There would be initial adverse effects but, over time, resources would be re‐allocated to other industries and regions.

The provision of service at the cellar door is now beginning to attract some attention, which is critical given that wine tourism is a very lucrative industry with the ability to generate substantial wealth and growth. This paper develops the application of the SERVQUAL research approach, already used in Margaret River, and applies it to the Barossa Valley. It outlines the results of a survey in the latter region, and draws some comparative conclusions with the Western Australian data. It produces some conclusions about those features deemed important by visitors in their overall satisfaction ratings of the cellar door experience including the impact of that experience on subsequent purchase behaviour, and it also highlights some of the differences between wine tourists in the two states.

The Maturity Matrix is a tool designed in the UK to assess family practice organisational development and to stimulate quality improvement. It is practice‐led, formative and undertaken by a practice team with the help of trained facilitators. The aim of this study is to assess the Maturity Matrix as a tool and an organisational development measure in European family practice settings.

Using a convenience sample of 153 practices and 11 facilitators based in the UK, Germany, The Netherlands, Switzerland and Slovenia, feasibility was assessed against six criteria: completion; coverage; distribution; scaling; translation; and missing data. Information sources were responses to evaluation questionnaires by facilitators and completed Maturity Matrix profiles.

All practices taking part completed the Maturity Matrix sessions successfully. The Netherlands, the UK and Germany site staff suggested including additional dimensions: interface between primary and secondary care; access; and management of expendable materials. Maturity Matrix scores were normally distributed in each country. Scaling properties, translation and missing data suggested that the following dimensions are most robust across the participating countries: clinical performance audit; prescribing; meetings; and continuing professional development. Practice size did not make a significant difference to the Maturity Matrix profile scores.

The study suggests that the Maturity Matrix is a feasible and valuable tool, helping practices to review organisational development as it relates to healthcare quality. Future research should focus on developing dimensions that are generic across European primary care settings.

The purpose of this paper is to identify factors predisposing to risk in publications written by healthcare professionals, especially those concerned with medicines.

Observation, discussion, and analysis of production methods, standards, and written outputs produced by the UK Medicines Information network as an exemplar of a healthcare organisation producing an array of publications with an accompanying tier of pre‐publication quality assurance procedures.

The factors which affect the likelihood and impact of risk in publications can be identified: author competence, quality of information sources, transformation process, audience, provenance, intended use and subject matter. These factors can be used to score a given publication and establish its risk potential relative to other publications.

It is recommended that healthcare organisations engaged in producing written material consider carefully the risks inherent in publishing, and the factors which influence risk.

The factors identified here can be used to score relative risk and to identify the highest risk publications. Higher risk documents should attract the most stringent pre‐publication quality assurance procedures.