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  1. Graham Towl
  1. Correspondence to Graham Towl, Durham University, Old Shire Hall, Old Elvet, Durham DH1 3HP, UK; graham.towl{at}

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UK consultants are in the upper quartile for pay but in the lower quartile for productivity according to Mark Britnell, the global lead on healthcare at KPMG.If we are to ensure the best quality mental health services for our patients we need to engage with learning from our colleagues internationally, specifically we need to be more productive. If we are to achieve this then the importance of an evidence-based approach surely cannot be in serious doubt. Without such an approach we may produce improved efficiencies without parallel improvements in effectiveness.

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