The reforms of the National Health Service (NHS), which commenced in April 1991, were designed to transform the provision of health care in Britain. These reforms included a commitment to medical audit, the formal evaluation of the practice of doctors, as part of a general move towards accountability and evaluation within professionalized health and welfare services. “The development and adoption of agreed standards of good practice,” argues The health of the nation, which was published in 1992 by the Secretary of State for Health, “is particularly important. The recent developments in clinical audit are to be commended and should be built on” (HMSO 1992, 30).