Dr Shipman, who worked as a family doctor in a single-handed practice in Hyde, Greater Manchester, was convicted of 15 murders. But an official UK Government inquiry found that he was responsible for at least 236 deaths over 24 years.

The Papworth Hospital team analysed the Shipman murders and, with the permission of a surgeon and anaesthetist, added in a similar pattern of unexplained virtual deaths to their individual records dating back to April 2000.

They discovered that the hospital's monitoring system would have rung alarm bells at eight months for the surgeon and ten months for the anaesthetist, as the actual death rates would have fallen outside the tolerance zone for predicted death rates.

Papworth is England's main heart and lung transplant centre and its 1,300 staff treat more than 20,000 inpatients and day surgery cases each year, together with 20,000 outpatients.

Both the surgeon and anaesthetist chosen by the authors to take part in the study had been working at the hospital for more than six years. Their performance figures were closest to the average death rates recorded for all staff at the hospital working in their specialty.

The virtual deaths were added into the hospital's point-of-care deaths records, which include details of the patient, operation performed, the outcome and the risk attached to that particular procedure.

Data from these records are analysed once a month by the hospital's clinical audit team and the results from the previous 12 months examined in detail. Annual audits are also carried out on the data, which have been validated by external assessors.

"The system at Papwor
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Contact: Annette Whibley
wordwizard@clara.co.uk
Blackwell Publishing Ltd.
10-May-2006