Introduction

Why should clinicians be involved in clinical audit? Amongst some clinicians there is open hostility to the concept of formal audit of medical practice. Further, with the introduction of the National Health Service (NHS) reforms and the devolvement of financial control to the level of consultant clinicians the resistance to particularly the resource aspects of audit is even more apparent.

The managers want waiting lists reduced, waiting times in clinics to be at a minimum and a cost-effective service provided, but they also expect the clinicians to be directly involved in the management structure and to provide much of the managerial information. The ‘big brother’ concept plays a significant role in the fears of the imposition of formal audit. Cries of loss of clinical freedom abound as clinicians are asked to justify their actions to the purse holders.

Before the answer posed in the title of this chapter can be approached it is necessary to define what has been the role of audit to date. The Working for Patients White Paper and Royal College directives on clinical audit have changed the perception of clinical audit and along with this change in perception the fears have grown. Audit of all aspects of medical practice has been around and undertaken for many years.