Published: 30/06/2005, Volume II5, No. 5962 Page 20

Stephen Thornton, chief executive, The Health Foundation

'Stroke of genius' (pages 26-28, 2 June) illustrates well how clinical audit can provide the impetus for service improvements and bring about direct benefits to patients.

Impressed by the work of the Royal College of Physicians, The Health Foundation has just launched its own£4m initiative, Engaging with Quality.

Awards have been made to royal colleges and other professional organisations to let eight clinical quality measurement and improvement projects to begin.

These will run for three to five years and will identify gaps between current and best practice and implement improvements. Among the issues being examined are maternity services, cancer, mental health prescribing, self-harm, epilepsy and respiratory diseases.

The transformation of stroke services at London's Royal Free Hospital demonstrates how critical it is for senior management to support clinician-led quality improvement. Indeed, the new consultant contract technically provides time for consultants to participate in this sort of endeavour, and they need to be allowed to do so.

That is why the success of the Health Foundation-funded projects will depend on managers encouraging clinicians to prioritise and to participate in the work, from contributing the necessary data to piloting service improvements, and securing necessary support services, not least information systems.

Ultimately, only effective teamworking between clinicians and managers will produce marked improvements in the quality of patient care.