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A step towards effective self regulation

BMJ 1999; 318 doi: (Published 10 April 1999) Cite this as: BMJ 1999;318:1017
  1. Stephen A Smith, clinical director.
  1. Birmingham

    Ihave no doubt that there are wide variations in the quality of service delivered by specialist departments in different hospitals throughout the United Kingdom. Although this may partly be due to the skills of the clinical staff, much of the variation is determined by local factors, such as the availability of resources and organisational considerations.

    At present there is minimal exchange of information about clinical practice and outcomes between departments, which are isolated by distance, limited movement of staff, and, sadly, competition between rival trusts. The government and the media have focused on these differences, and it seems inevitable that external mechanisms will be devised to identify and eliminate unacceptably poor practice. As a profession we should try to do better than this.

    • The process is effective, relatively cheap, and immensely enjoyable

    The committee on renal diseases of the Royal College of Physicians of London has risen to this challenge by developing a protocol for …

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