ప్రాథమిక సంరక్షణలో నాణ్యత అందరికి ప్రవేశం

నైరూప్య

'Last seen before death': the unrecognised clue in the Shipman case

Guy Houghton

There have been very few mortality surveys at individual practice level. This lack of robust comparative information is one of the reasons why the full extent ofHarold Shipman’s possible murderous activities went unrecognised until Richard Bakerundertook his comprehensive study as a part of the o¤cial Shipman Inquiry. This review looks at 752 deaths over 11 years in a single suburban Birmingham practice. In addition to recording the age and sex of the patient, and the place and cause of death, the extra, previously unrecorded, parameter of when the general practitioner last saw the patient alive was included. Only 8% of patients were seen alive on the day of death, in comparison with Dr Shipman actually in attendance at almost 20% of his patients’ deaths. Although these are only the results of a single practice study, they o¡er a benchmark for further comparative data collection to deŽ ne patterns of mortality in the community. They also suggest only minor modiŽ cations to the notiŽ cation of cause of death procedures are needed to identify another Shipman.