Clinical audit plays a key role in advancing the safety of clinical care and better treatment of patients. Among the approaches to audit, analysis through independent review of events in the care of individual patients is one of the most powerful. In this form, it is considered that the confidentiality of the analysis is an important factor.

There are, as a result, clear tensions between the competing public interests of Freedom of Information and the participation of healthcare professionals in effective safety and quality programmes.

The accompanying memorandum, produced under the aegis of the Scottish Audit of Surgical Mortality, aims to promote discussion of these issues. It explores the potential for new legislation to maximize the participation of healthcare professionals in safety and quality programmes by providing for confidentiality of some of the information gathered by those programmes. It also outlines the responsibilities of clinicians and institutions in the conduct of confidential enquiries and reviews.

Freedom of Information legislation already recognises exemptions for categories of information where disclosure would not be in the public interest. Other countries, such as the United States and Australia, have framed legislation to protect identifiable information generated purely for the purpose of an approved clinical quality improvement process. Where such legislation has been introduced it has been with the wide support of the public and healthcare providers.

It is hoped that you will find the memorandum informative and stimulating. We would be very pleased to hear from you about these proposals and your views on how these would best be taken forward.

Qualified Confidentiality, Patient Safety and Freedom of Information Discussion Paper June 2005