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The way quality assurance has developed in the UK over the past three years is described. The lack of a national programme has meant that the onus has been on health districts. They have, however, been aided in their work in five ways: commitment from national and regional bodies, national quality assurance programmes with specific remits, training support for personnel, practical advice and the results of research projects. Not surprisingly, there has been considerable diversity in the approaches districts have adopted and the progress they have made.

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