Monitoring 'unlikely to detect another Shipman'

Researchers find that monitoring of practice mortality data is more likely to cast suspicion on innocent GPs.

Monitoring GP practices' mortality data is unlikely to detect another serial killer like Harold Shipman, claim UK researchers.

Routine mortality monitoring was one of the recommendations in the Shipman Inquiry into the former GP, convicted in 2000 of killing 15 of his patients. It is believed he killed over 200 in his 23-year career.

But statistical analysis has shown that the system is unlikely to detect a mass murderer and more likely to cast suspicion on innocent GPs.

Routine data from NHS Scotland was used to gauge that, on average, GPs tend to stay at a practice for three years and therefore this has to be the time frame in which to detect a mass murderer.

Researchers then looked at a dataset of 405,000 patients in 75 practices and searched for suspiciously high annual rates of mortality - fixed at five to 10.

Even the most sensitive method - cumulative sum charts - detected just over half of suspicious cases. This would mean 30 people over the three-year period would be killed before the method was likely to raise suspicion. Further still, it raised false alarms in more than 15 per cent of cases.

Reforms to ensure a proper account of every death, another recommendation of the Shipman Inquiry, would be more effective, researchers say.

'Mortality monitoring could at best operate as a support to catch a serial killer who has evaded detection by other means,' they write in the British Journal of General Practice.

Lead researcher Professor Bruce Guthrie, GP and academic at the University of Dundee, told GP: 'It would not be fit for purpose for detecting mass murderers.

'There's a difference between what we want to monitor - the doctor - and what we can monitor - the practice.'

BJGP 2008; 58: 311-7

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