Auditing for patients.

sumer expectations and changing professionalpatient relationships. In the NHS, recent reforms involving, for example, the introduction of commissioning, clinical audit, and the patient's charter, have given an additional impetus to quality. Some of the Audit Commission's earlier work in quality of health care was outlined in the previous supplement'; this paper describes the commission's subsequent thinking and actions and includes, firstly, a brief explanation of the commission's interest in and contributions to health service improvement; secondly, concepts of "quality" and quality management; thirdly, the issues likely to have a critical influence on further progress towards continuous improvement in the NHS; and, finally, the most appropriate "next steps" towards better quality health care and future plans.