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Book Review


Experience, evidence and everyday practice: creating systems for delivering effective healthcare. M Dunning, G Abi-Aad, D Gilbert, H Hutton, C Brown. King's Fund Publishing, London. ISBN 1 85717 239 6. pp 117. No price available. Available from King's Fund Bookshop Fax +(44) 171 307 2801.

This is a book that should be on the shelf of everyone at director level in a health service. It's journey to the shelf should be via well-thumbed pages and a split spine showing that it has been read and the contents digested. It is a synopsis of the 16 projects in the Promoting Action on Clinical Effectiveness (PACE) programme, which itself grew out of GRIP projects (see Bandolier 1 , 3 , 4 and 8 ).

The key message is that promoting effectiveness is a messy process requiring facilitation, flexibility and the ability to coax and cajole to drive the work forward. It also takes time, may be expensive on the steep part of the learning curve, and needs some lateral thinking, but can be highly rewarding. Examples given are just terrific - pointing out some of the often complicated ways that have to be used to make progress. But once you've read about them, you too have learned the hard lessons. So you too can get stuck in, knowing how to do it.

Pulling the lessons together - identifying the bricks in the wall of progress - is also accomplished, with simple lessons of how to survive and thrive in the complicated systems we call the NHS. Any NHS executive who hasn't read this book is not doing his/her job, because clinical effectiveness is the core of what the NHS is all about.
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