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

Area of Science:

• Healthcare Law
• Medical Ethics
• Clinical Governance

Background:

• Clinical audit is crucial for assessing healthcare quality against evidence-based standards.
• Disclosure of clinical audit records presents significant legal and ethical challenges, potentially impacting professional participation.
• Transparency in healthcare is important for patient trust but must be balanced with protecting sensitive audit information.

Purpose of the Study:

• To examine and compare legal frameworks governing clinical audit record disclosure in Ireland, England, and Australia.
• To evaluate the strengths and weaknesses of different jurisdictional approaches to protecting clinical audit records.
• To advocate for specific legal reforms in England concerning the disclosure of clinical audit information.

Main Methods:

• Comparative legal analysis of legislative and common law frameworks in Ireland, England, and Australia.
• Examination of existing safeguards and protections for clinical audit records in each jurisdiction.
• Evaluation of the implications of disclosure rules on healthcare professionals and patient safety.

Main Results:

• Ireland offers strong legislative protection shielding clinical audit records from disclosure.
• Australia employs a qualified privilege model, allowing court overrides in the interests of justice.
• England currently lacks comprehensive safeguards, with limited protection under new 'safe space' legislation for specific investigations.

Conclusions:

• England's legal framework for clinical audit record disclosure requires reform to better protect sensitive information.
• Expanding England's 'safe space' model, inspired by Australia's qualified privilege, is recommended.
• Clearer exceptions and guidance are needed to balance protection with professional and statutory duties of candour.