Promoting quality improvement: navigating the conundrum in clinical audit record disclosure

Clinical audit is an essential tool for improving clinical practice by assessing care against evidence-based standards. Yet, the disclosure of clinical audit records raises complex legal and ethical challenges. While transparency fosters patient trust, it also risks discouraging healthcare professionals from full participation due to potential reputational and legal consequences. This article examines the legal frameworks governing clinical audit record disclosure in Ireland, England, and Australia, highlighting key differences in each jurisdiction's approach. Ireland recently introduced legislation that shields clinical audit records from disclosure, whereas Australia's qualified privilege model provides conditional protection that courts may override in the interests of justice. In contrast, England lacks explicit safeguards except for its newly introduced 'safe space' legislation, which applies only to Health Service Safety Investigations Body investigations. Through comparative analysis, this article evaluates the strengths and weaknesses of each approach and advocates for reform in England. It argues for expanding England's 'safe space' model to align more closely with Australia's qualified privilege framework while addressing its limitations by introducing clearer exceptions and explicit guidance on its interaction with the professional and statutory duties of candour.