HQIP study into audit job roles reveals wide inconsistencies across NHS

9 June 2010

Results of HQIP's detailed analysis into job descriptions and Knowledge and Skills Framework (KSF) outlines for clinical audit staff have been released - with the four reports throwing up wide inconsistencies across the NHS and other organisations.

Five key themes emerged:

• Wide variation in the way clinical audit is managed within NHS organisations
• Clinical audit expertise not recognised through salary bands 6, 7 or 8
• Little consistency in the use of job titles or role descriptions
• Job descriptions mostly task-orientated and missing strategic, leadership or influencing roles
• Wide variation in lines of accountability and reporting for clinical audit depending on the organisation's perception of the purpose and function of clinical audit

The study forms part of a project to develop job descriptions and KSF outlines for clinical audit staff. For this HQIP commissioned Healthcare Quality Quest (HQQ) to carry out a review of published job descriptions of clinical audit staff working in the NHS and other relevant organisations.

HQIP response to study findings >>

The aim of the review was to learn about roles and responsibilities for clinical audit staff, salary bands and any other information related to structures for clinical audit jobs in NHS organisations.

Below are links to all the reports contained within the review, and an official response to the findings from HQIP National Lead for Local Clinical Improvement Kate Godfrey.

Download the reports:

• Report on Job Descriptions, Person Specifications & KSF for Clinical Audit Staff (part 1) >>
• Report on Job Descriptions, Person Specifications & KSF for Clinical Audit Staff (part 2) >>
• Report on Published Job Descriptions for Clinical Audit Staff >>
• Report on Clinical Audit Staff Structure >>
• Report on Specifications for Job Descriptions, KSF & Employment >>

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Official HQIP response to the HQIP job descriptions and Key Skills Frameworks study

By HQIP National Lead for Local Clinical Improvement Kate Godfrey

HQIP strongly supports the principle that only clinicians can carry out effective clinical audit, which results in improved patient care, with the support of suitably qualified and experienced clinical audit professionals.

As part of our commitment to support NHS organisations to further develop their quality improvement systems and processes we asked Healthcare Quality Quest to carry out a survey of clinical audit staff and a review of published job descriptions for clinical audit staff in NHS organisations.

The key themes that emerged from this work are:

• There is wide variation in the way clinical audit is managed within NHS organisations
• High level expertise in clinical audit is not recognised through salary bands 6, 7 or 8.
• There is little consistency in the use of job titles or role descriptions. Clinical audit facilitator is a commonly used job title but ranges between salary band 4 and 6.
• Job descriptions are generally task orientated and do not include strategic, leadership or influencing roles
• The lines of accountability and reporting for clinical audit differ depending on the perception of the organisation regarding the purpose and function of clinical audit

HQIP supports the recommendations of this report as follows:

• A better understanding of the roles and responsibilities of clinical audit staff in relation to assurance and quality improvement is needed throughout the NHS.
• The role of the clinical audit manager is key in order to for there to be a clear focus on the accountability and responsibility for an NHS organisation's performance in clinical audit.
• Expertise in clinical audit should be recognised through the creation of specific non managerial roles at grades 6 and 7 in order to promote the scientifically-based knowledge about best practice in clinical audit. The job titles used for this role should reflect this e.g. clinical audit specialist or practitioner.
• There is a separation of the various jobs under the title clinical audit facilitator and that a single appropriate salary band is used. The post holder should be encouraged to aspire to the higher salary band jobs - clinical audit specialist / practitioner.
• The title of clinical audit assistant is used in place of titles such as ‘data input clerk' so that the organisation can use these positions more flexibly and individuals in these roles can carry out a greater range of tasks