Introduction

The practice of medical audit, like the practice of clinical science, demands a mixture of creativity and critical analysis.

In this chapter, our primary concern is to provide general medical and general dental practitioners with some methods of tackling audit in their practices, but before auditing any phenomena, it is useful to know what audit is, what auditing is for and what one is auditing. At first sight the answers to these questions may be found in Working with Patients and the accompanying Working Paper No. 6 on medical audit. Soon after publishing these papers the Government belatedly recognised that audit embraces much more than accounting; that it is a deep subtle process; that it has implications for practice management and that it is inextricably linked with professional standards and continuing professional education. The confusion that is implicit in the Government's policy is now being felt explicitly in practices that are beginning to tackle the problems of audit. Hence this chapter.

What is audit?

To audit is to estimate worth. Audit is the ugly sister of the family of assessment. Its near relatives are total quality management, appraisal, quality assurance and quality control. Marinker defines medical audit as ‘the attempt to improve the quality of medical care by measuring the performance of those that practice that care, by considering their performance in relation to desired standards, and by improving on this performance’.