Accountability, audit, and standards of practice in the UK

In the wake of the judgments set out by the General Medical Council of the United Kingdom and the likely further investigation of the Wisheart case involving a series of neonatal and infant deaths during cardiac surgery, the profession has had to produce a swift response in its attempts to retain some level of self regulation. At the British Medical Association conference in June this year, an almost unanimous vote was obtained in support of the notion of regular appraisal of current medical practice. The government decision to publish league tables of hospital mortality rates for England and Wales, bringing these parts of the UK into line with the position in Scotland, has helped to focus attention on the need for setting and monitoring standards of good clinical practice (GCP). The profession has already begun to feel the pressure for external evaluation, for instance in the declaration of intent by the government to introduce a scheme of inspection of hospital trusts by an independent watchdog, similar to that which has been introduced by the Office for Standards in Education to police high school education.

Many in the profession think that schemes of this nature will be difficult to set up and control and will require careful planning. However, they are to be welcomed and indeed …