Harold Shipman's clinical practice 1974-1998 : a review commissioned by the Chief Medical Officer

This audit of the clinical practice of Harold Shipman was commissioned by the Chief Medical Officer for England following the conviction of Dr Shipman for the murder of 15 of his patients.

The aims of the audit were to identify: the pattern of observed deaths in particular age groups; deaths showing unusual clusters in time; deaths showing unusual clusters by place of death; the relationship between certified cause of death and medical history; the integrity of records; the prescribing of restricted drugs.

The sources of information used were: the medical certificates of cause of death (MCCDs) issued by Shipman and those issued by a comparison group of local general practitioners; surviving clinical records and cremation forms; data provided by the Prescription Pricing Authority and controlled drugs registers at pharmacies in the area where Shipman worked.

This clinical audit reveals clear evidence of a higher level of deaths than would have been expected over a long time period.

The excess of deaths does not appear to be explicable on grounds that his practices served populations with markedly different demographic or health profiles.