Psychiatry is unique in already being subject to statutory external audit through regular visits to psychiatric hospitals and units by the Hospital Advisory Services and Mental Health and Mental Welfare Commissions. These organisations do comment on aspects of the standard and quality of care. Reports of their findings undoubtedly facilitate change. By their programme of repeated visits they are in a position to observe the implementation and outcome of altered patterns of practice brought about by their reports. The Codes of Practice being prepared by the Mental Health Commission (England and Wales) and Mental Welfare Commission (Scotland) is another step that will significantly influence clinical practice. Finally, the Royal College of Psychiatrists' postgraduate training scheme accreditation exercise, like those of the other Royal Colleges and Faculties, has had an impact on quality of clinical care through its policy of gradually increasing the standard of postgraduate clinical training requirements. Locally based audit clearly complements these external exercises and local psychiatric services are now expected to organise systems of regular internal audit as are the other clinical disciplines (Department of Health, 1989).