Describes how the Buckinghamshire Medical Audit Advisory Group have approached the introduction of medical audit in primary care. Outlines how the original facilitator model, which proved so successful in encouraging initiatives in coronary heart disease prevention, is now being used to encourage and promote quality initiatives using medical audit techniques. Explores use of the audit cycle and emphasizes the importance of teamwork in enabling change to occur. Outlines the special personal and professional skills required to work in the increasingly complex and dynamic arena of primary care, with a description of how the National Facilitator Development Project has taken on board these educational needs.

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In 1997, the authors conducted a survey of registered nurses working in the academic departments of general practice and primary care in UK and Irish medical schools. The survey aimed to determine the number, demographic and professional profile of nurses employed in these academic departments, including their employment status and their views on their clinical work and professional development. The majority of nurses were professionally experienced, had higher degrees, worked in a research capacity, and were likely to have short-term contracts. Contrary to professional perceptions, the majority of nurses stated that clinical work is important to their current job and expressed a need for research support and recognition of their autonomy as healthcare professionals.