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The Government’s consultative document Patients First proposes a number of changes in the structure and management of the National Health Service. These are unlikely to help the NHS address the fundamental problems facing it, and will probably divert attention away, much as the last reorganisation in 1974 appears to have done. The key policy questions concerning objectives for the NHS and appropriate resources to make it work better are discussed.
This article reviews what has happened to put into effect the commitment to more evidencebased policy and practice in the UK, by identifying the opportunities this has offered to the research community and reflecting on the ways in which researchers have responded. It identifies a number of issues that remain unresolved and offers an agenda for those who are committed to advancing the application of evidence to policy and practice in the UK and elsewhere.