The need to base health care decisions on robust evidence is growing, under pressure from an ageing population, new technology and rising patient expectations. This bulletin looks at how evidence is being used at a strategic level within health boards and how it is influencing the planning process. It also considers the priority being given to the implementation of evidence-based healthcare. It was found that evidence is having an increasing effect on the planning process, but there are a number of other important influences, including national guidance and expectations, pressure from the media and the public, and different values. The advent of clinical governance may address some of the areas of concern and uncertainty highlighted in the bulletin.