An audit was carried out on 250 patients who attended an acute orthopaedic clinic following referral from the Accident and Emergency Department. Of the patients 17.2 per cent had an incorrect diagnosis made, and 12 per cent of the patients had been incorrectly treated. Of all plaster splints 49.4 per cent were removed, and 25.4 per cent were substantially altered by the orthopaedic staff. Six per cent of patients were admitted from the clinic. The implications of these results on the need for audit and direct feedback in order to improve the quality of care and efficient use of resources are discussed.