In conclusion, Essence of Care benchmarking is a sophisticated clinical practice benchmarking approach which needs to be accepted as an integral part of health service benchmarking activity to support improvement in the quality of patient care and experiences.

It is unacceptable for health care professionals to acquiesce quietly to inconsistencies in the quality of health care received by patients. In the United Kingdom, the introduction of clinical governance has formalized the expectation that professionals' practice will meet recognized standards of care consistently. It is being stated that all available evidence is being used to identify national standards of excellence. This will inform professionals not only of expected outcomes but of also the structures and processes that need to be in place to support the attainment of such outcomes. Clinical practice benchmarking is one continuous quality improvement approach, which is being used by paediatric units in 27 National Health Service Trusts in the north-west of England to promote the utilization of available evidence in to practice. The evidence base for benchmarks of best practice is considered continuously using a hierarchy of evidence. This clarifies the different evidence available, upon which benchmarks or standards of excellence can be based, but reinforces the kudos awarded quantitative research evidence within health care. Once benchmarks have been agreed, benchmarking activity supports practitioners in a continuous cycle of comparison and sharing that is aimed at ensuring that children and their families receive evidence-based care, wherever they are admitted in the north-west of England.

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When feasible, the optimal approach may be for oncologists to work with genetic counselors to provide pretest education and medical recommendations. Elicitation of patients' preferences may be useful to determine the level of counseling services needed.

Benchmarking is a relatively new addition to NHS quality initiatives. This article describes how a group of paediatric nurses set up a project to introduce benchmarking across units in the north west of England, and explores the benefits and disadvantages of this approach for nursing in general.