Except for a few local schemes, monitoring systems are not yet established, report the authors. They suggest that procedures for investigating abnormal patterns need to be agreed, and that a monitoring system could detect high death rates by using valid comparative data.
Monitoring should also be practical, and not be unduly complex or costly to administer. A monitoring system must be:
They admit that there will still be limitations. For instance, monitoring subgroups of GPs, such as locums, assistants and those caring for people in hospices would be difficult, and in practices where individual patients are treated by more than one doctor, analysis would have to be by practice rather than by doctor.
"Monitoring mortality rates among general practitioners' patients would help maintain public trust," they say. "Better information about mortality rates in general practice could also facilitate the planning and monitoring of clinical policies to gradually reduce mortality."