In one sense all medical care is a “trial of one” and certainly the access to medical records collected in a structured way can be helpful in identifying trends in treatment and care, for generating new ideas and for the trial of therapies in a working as opposed to a laboratory situation.

More importantly is the need for an organisation to test out and learn what works, what works well and what works better. Evidence based medicine and national studies may be of interest but what is crucial is what works best in this environment for this disease.

Research also underwrites Clinical Audit and Quality control, the methodology and the discipline of collecting data in a standard way, analysis and interpretation require the tools and rigour of the scientist.

Management research is equally important and often neglected - what is the best-most cost efficient and effective way of staffing, running and maintaining a particular service.