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As quality of care is so high on the agenda of practitioners and policy makers, it is surprising that there are no systematic reviews of studies of the level of quality provided by healthcare services. In this issue of Quality in Health Care Seddon and colleagues report a systematic review of studies on the quality of clinical care in general practice in the UK, Australia, and New Zealand.1
The authors found that many published reports were methodologically poor and therefore only limited conclusions could be drawn from the findings. Around 90 papers were identified and, not surprisingly, the majority related to management of chronic care and only two related to acute conditions. Practices that took part in the studies were often self-selected, and many of the reports were from single practices. Despite publication of numerous evidence based guidelines in recent years, the authors found that clinical care in general practice consistently failed to meet high …