In the 1997 White Paper 'The New NHS, Modern, Dependable' the Government set out its plans for a new NHS with quality at its heart (a vision shared by many health professionals).This book explores the application of the various approaches to quality assurance. The development of the subject, from its early days to the latest initiatives including guidelines, integrated care pathways and the new clinical governance instrument 'Probe', is explored as is its relevance to the pursuit of excellence.