This book is all about improving the quality of care in gynaecological practice, particularly women's health, recognising that quality in health care is a continuously evolving process. The models of care are rooted in the Standards for Gynaecology that have evolved over recent years, derived from clinical guidelines, consensus recommendations and increasingly women's needs. The individual chapters reflect the fact that the main drivers for improvement are clinical effectiveness, and increasing patient expectations. In each area of practice described here, there is recognition that the appropriate clinical response to these drivers is service organisation. Clinicians need to take responsibility not only for managing individual patient conditions but also for developing services which meet patients' needs.

Importantly, this book also reflects the understanding that clinical developments will only come about if clinicians take the initiative to ensure that improvements happen and, at the same time, act in the interests of the total patient population they serve, including, perhaps most importantly, those who have most difficulty accessing services. Clinical governance is the primary responsibility of all consultants in obstetrics and gynaecology and, crucially, this includes the development of effective and responsive clinical services.