Volume 11 Number 3 contents

Editorial

Harnessing the winds of change
P Brambleby and T Wright

Personal perspective

Current pressures in gynaecology services: a solution through backward integration to manage demand by joint pathways of care with primary care trusts
D Liu

Management issues in healthcare

Making the NHS functional: the 'ACT' model
L Wood and I Robert

Managing medical leave
N Renshaw

Evaluation of a specialist outreach clinic in a primary healthcare setting: the effect of easy access to specialists
A Leiba, G Martonovits, R Magnezi, A Goldberg, J Carroll, P Benedek, N Ohana, R Leiba and Y Bar-Dayan

National monitoring of clinical effectiveness using the SF-36 questionnaire: using the results for revalidation and clinical governance
A Vallance-Owen and S Cubbin

Measuring performance in a service department
J Watts and J Watts

Commentated case study

Best of intentions

Book reviews