Where have all the pennies gone? The work of Manchester medical audit advisory group

Abstract

Medical audit has its critics, who point to the large sums of NHS cash that seem to be disappearing down a medical plughole. These criticisms are recognised by medical audit advisory groups but there are many reasons why the work of these groups has not yet resulted in many publications in journals or bumped up health indicators. After discussing the criticism this article describes the work of the medical audit advisory group in Manchester. Real changes in cooperative working with general practice teams and between practices are taking place, and improved relationships between general practice and the hospitals are being helped by joint audit work. The Manchester group is also working to help in setting standards and to cooperate with purchasing. The work of the group is changing as it develops. In my role as chairman of the medical audit advisory group in Manchester I am accountable to my family health services authority on behalf of my group. I am also accountable to the general practices and to their patients, and to taxpayers, for the money that has been spent on audit of primary care in Manchester. In this article I first mention recent criticism of medical audit, then discuss the reasons for the lack of indicators of the success of audit at this stage. The work of the Manchester group argues that continuing support for medical audit advisory groups is justified but that they should welcome continuing evaluation. Medical audit in the NHS has come under criticism. The critics are important and influential voices and deserve a response. From the health economists’ perspective Professor Alan Maynard, writing in the Health Service Journal,1 and Professor Martin Buxton, speaking at a 1993 London conference on raising quality in the NHS, have both identified the large sums of money spent on …