Achievements of audit in the NHS

Audit, now usually described as the "systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome for the patient,"' is seen by many as an inherently "good thing": an activity that by definition deserves support and encouragement.Certainly, the NHS reforms gave a blanket endorsement to audit, requiring all doctors to be involved on a regular basis.Russell and Wilson added to its stature by 'describing it as "the third clinical science, with its own theories, techniques, and literature,"2 and argued that, if undertaken appropriately audit "has the potential to deliver substantial benefits to patients and health professionals."However, it is appropriate to stand back and view audit as just one more health technology competing for scarce healthcare resources.It is an organisational technology, well within the standard definition of technology,3 and it should be subject to rigorous assessment, in the manner now properly being demanded for all health technologies.4To use the terminology of the diffusion of a on