Total quality management in the NHS.

In 1989, the Department of Health embarked upon a programme to encourage the introduction of a managed approach to quality in the NHS. In 1990 it extended this programme to include 23 sites ranging from departments within units to total districts. The criteria for inclusion in the programme were loose, but all successful pilots marched under the banner of total quality management (TQM), a clearly defined concept with a well-documented history. Tessa Brooks summarises TQM and considers its place in the NHS.