AbstractThere is no large literature on evidence-based policy-making. We do know that one of the most difficult decisions is about the dependability of evidence we use to make policy. Unless the evidence can fulfil the criteria of quality, validity, and size, then it has the potential to mislead us, whatever study designs or methods have been used. The best examples of evidence-based policy-making come from development of care pathways, in which multidisciplinary groups merge best-available evidence with what is possible in local circumstances. These care pathways almost always have the ability to deliver better care for patients, with less fuss for professionals and at lower cost to the community. They may be the single best way of improving healthcare.