Health systems internationally have developed policies to support evidence-based health care (EBHC) for over a decade. As this article shows, the time is ripe to review current policy frameworks in an evidence-based manner. We summarize key themes deriving from qualitative research on the UK EBHC implementation and draw out implications for policy renewal. Our diagnosis is different from current UK NHS (National Health Service) policy since we stress local capacity building rather than top-down frameworks, standardized tools and guidelines. As other jurisdictions demonstrate alternative EBHC policy frameworks, more international comparison and mutual learning is needed. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd.