Approaches to medical audit.

The last two or three years have seen an explosion of interest in medical audit, a phrase hitherto barely used in the UK except by a few hardy pioneers (for references, see' 2). Then in quick succession in the last two years appeared the Confidential Enquiry on Perioperative Deaths,3 the Report of the Royal College of Physicians on Medical Audit,4 and the White Paper "Working for patients".5 The White Paper provided a helpful definition of audit: "a systematic critical analysis of the quality of medical care, including the procedures used in diagnosis and treatment, the use of resources, and the resulting outcome for the patient". Since the publication of these documents, there have been several conferences about medical audit, and local health authorities in the UK should by now have established "District Audit Committees". It is perhaps a useful time to take stock ofthe situation, and ofthe different approaches to medical audit, and attempt to predict the way in which matters are likely to develop over the next few years.