- Julie Billett, specialist trainee in public health (juliebillett@yahoo.co.uk),
- Nick Kendall, assistant director of public health,
- Peter Old, associate director
- Adur, Arun and Worthing Primary Care Trust, Goring by Sea, Worthing BN12 6BT
- National Clinical Assessment Authority, London SW8 5NQ
EDITOR—Like Mohammed et al, we investigated several general practitioners (GPs) who signalled as having “unacceptably” high death rates in the study undertaken by Aylin et al.1 2 We also concluded that these higher than expected death rates were explained by a “nursing home effect.”

Credit: JOHN GILES/PA
Our methods included calculating standardised …
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