Health-care planners, policy makers, economists, purchasers and providers faced with increasingly limited resources, are attracted by the prospect of reliable evidence on costs and effectiveness^1,2. The practice of evidence-based health care could ultimately lead to a redirection of resources towards treatments shown to be more effective than the alternatives. Evidence-based health care should extend the scientific methodologies to aspects of NHS activity other than clinical work. As a result there are wider cultural implications through the participation of staff in the identification of problems that are appropriately tackled by research³.