Dr. Gabriel Scally:

Audits should always be done. The decline of clinical or medical audit over the past decade or two is deeply regrettable. It is a question of how it is done, the purpose for which it is carried out and the rigour with which it is applied. Also, in the conception of the audit, attention must be paid to the communication of its results and the aftermath of any errors. As I noted, we do not have a good system for dealing with clinical error when it occurs and responding as a society to clinical error. The audit cannot merely be entirely clinically driven without paying attention to all those downstream elements. In some jurisdictions, those elements are so difficult to deal with that they do not do audits. Instead, they rely on accreditation, quality assurance and training to generate assurance that the system is good because it is a very difficult area to get into.