HQIP transparency strategy: national clinical audits set for clinical team-level reporting

26 January 2012

The Healthcare Quality Improvement Partnership (HQIP) today announces a comprehensive strategy designed to meet the Government's transparency agenda regarding clinical audit, and bolster it in terms of ensuring more localised results are made public, making findings more accessible for patients, reducing time lag between data gathering and publication and an increased focus on the implementation of audit results.

A number of initiatives are included in the first wave of announcements, including:

• Results of the National Lung Cancer Audit pilot study available on Data.Gov.uk for first time
• Timetable for all other relevant National Clinical Audit and Patient Outcomes Programme (NCAPOP) audit data to be made available on Data.Gov.uk
• Comprehensive new rules for NCAPOP audits to ensure information is more granular, more widely available and more accessible for patients and the public
• A new, publicly available search portal for national audit participation and case ascertainment rates
• The launch of an online system for NHS staff to feedback on national audits, designed to highlight areas for improvement within existing audits

In his ‘Transparency and open data' letter to Cabinet Ministers on 7 July 2011 (see ‘Links' link at bottom of page), Prime Minister David Cameron announced a new commitment to make available clinical audit data from audits within the National Clinical Audit and Patient Outcomes Programme (NCAPOP), which are commissioned and managed by HQIP. 

The National Lung Cancer Audit (NLCA) was identified as the pilot for this and the results are now available on data.gov.uk (see below). Covering all Cancer Networks and NHS Trusts in England, the data contains information including the process of care given to patients; information about care outcomes and treatment; audit participation by Trust and also data completeness.

NCAPOP covers 29 of the most commonly occurring medical conditions, rising to 40 in the coming years, measuring the treatment patients receive and outcomes of that treatment. With the NLCA pilot in place, HQIP can now confirm that all other relevant clinical audits will follow suit, with information from the latest annual reports available on data.gov.uk by 30 April 2012.

Health Minister, Lord Howe said: "These are crucial first steps in opening up health data for public scrutiny and analysis. The National Lung Cancer Audit data is an invaluable resource relating to a disease that kills more people in UK than any other form of cancer. Together with the release of clinical audit data across further clinical areas and HQIP's wider plans for accessibility and accountability, patients will benefit directly from audit data now readily available in a new, more flexible format helping to drive improvements in treatments and patient care. We will set out our vision on how information can support greater choice and improved care when we launch our Information Strategy in the Spring."

Going forward, HQIP today issues rigorous new guidelines for the organisations it commissions to carry out NCAPOP audits. These are designed to ensure that audit results are available at the most granular level possible, are created and distributed in such as way as to make it simple for patients and other lay individuals and groups to access and understand.

In practice, this is likely in most cases to see Trust-level reporting of results within all NCAPOP audits. Where possible this will go further, and see reporting at clinical team-level. For example, the National Joint Registry, which monitors the performance of hip, knee and ankle implants and is the largest database of its kind in the world, is aiming to move toward surgeon-level reporting. The guidelines (see below) also contain clear rules on reducing the time between data being collected and published with increased focus on how results of previous reports have been implemented.

Transparency and accessibility of clinical audit data is to be further supported with the launch of two online resources by HQIP. The first is a new search portal for national audit participation and case ascertainment rates - an updated version of the current raw data-based PARCAR system - and the second initiative will see the launch of an online system for NHS staff to feedback on national audits, launching this spring.

"This comprehensive strategy and its raft of initiatives solidly support the wider transparency agenda - not just in terms of making data available, but also making it accessible and understandable to patients and the public and focusing on implementation," says HQIP Chief Executive Robin Burgess.  "Clinical audit is about tangibly and fundamentally improving the healthcare patients receive and the outcomes of that healthcare provision. This strategy is a solid platform to quickly establish whether that is happening and, if necessary make the right changes to ensure it does going forward."

LINKS:

• Government Transparency announcement regarding clinical audit
• NLCA pilot results
• HQIP reporting guidelines
• PARCAR (current version presenting data in raw format)