Investigation into GPs with high patient mortality: Monitoring death rates will become increasingly complex

doi:10.1136/bmj.329.7461.350

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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.”