Using clinical audit to promote evidence-based medicine and clinical effectiveness--an overview of one health authority's experience.

Health care purchasers are facing increasing pressure to make the best use of their limited resources and to purchase only those services known to be clinically effective. This paper describes one health authority's experience of promoting clinical effectiveness through clinical audit and clinical guidelines. It highlights the central role of public health physicians in working closely with clinicians on the one hand and managers on the other, to promote evidence-based medicine. The recent changes in the funding arrangements for audit have allowed purchases to have more say in what should be audited, and link audit and clinical effectiveness with contracts.