Education And Debate

Personal paper: Disclosure of clinical audit records in law: risks and possible defences

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7119.1369 (Published 22 November 1997) Cite this as: BMJ 1997;315:1369
  1. Christopher Womack, chair, clinical audit committee1,
  2. Susan Roger, clinical audit coordinatora,
  3. Mandie Lavin, risk and litigation managera
  1. a Departments of Clinical Audit and Risk and Litigation, Peterborough Hospitals NHS Trust, Peterborough PE3 6DA
  1. Correspondence to: Dr Womack
  • Accepted 28 May 1997

Introduction

Clinical audit records have some degree of protection. The BMA recommends that access to audit information should be limited “to only those individuals, within the organisation, with a legitimate interest,” the organisation having further privilege” to control and restrict anonymised audit information for external organisations or individuals.”1 The code of practice on openness in the NHS aims to ensure, among other things, that people “have access to available information about the services provided by the NHS,” including “quality standards.”2It does not, however, propose publishing information about the performance of an individual clinician or the quality and outcome of the care of individual patients.2 The code also detailsinformation that may be withheld, and clinical audit records may fall into one or more of the four following exempt categories:

  • Personal information—people do not usually have right of access to details of other patients' diagnoses, treatments, or outcomes

  • Internal discussion and advice—this is to ensure that frank internal debate is not inhibited

  • Management information—this applies if clinical audit records are considered to be administrative (see below)

  • Information given in confidence—this applies to all clinical records unless outweighed by the public interest

Strict guidelines in this clinical audit department cover security, dissemination, and disposal of audit information, over and above the trust employees' obligation and the Data Protection Act.

Summary points

Clinical audit assesses clinical practice against agreed standards—it is an educational process that aims to improve patient care

Audit may uncover activities that fall short of the standard, and to encourage participation and enable uninhibited discussion and resolution of these problems, clinical audit is protected by restricted access and anonymised patient and …

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