The National Clinical Audit Programme

Anxiety and Depression

The National Clinical Audit of Anxiety & Depression will focus on improving care received by people during and after a period of inpatient treatment, including access and acceptability of services; waiting times and management between referral, assessment and treatment; access to services at times of crisis; employment support; training and supervision of therapists; and pharmacotherapy use.


Schizophrenia affects almost 300,000 people in the UK. The National Clinical Audit of Psychosis audit will focus on key concerns about treatment of people with severe mental illness including: access to services; delivery of evidence-based pharmacological and psychological therapies; quality of physical health care; and social exclusion. It aims to increase the quality of care that NHS Mental Health Trusts in England and Health Boards in Wales provide to people with psychosis.

National Audit of Breast Cancer in Older Patients

In the first year, NABCOP will conduct an organisational audit and define a set of process and outcome indicators. NABCOP will only use patient-level data that have been collected by the cancer registration services in England and Wales. NHS hospital trusts and health boards will be contacted by the NABCOP team during October 2016 with instructions for participation. The first report from NABCOP will be published in spring 2017 and yearly thereafter.

Arthritis: Rheumatoid and early inflammatory

The National Clinical Audit of Rheumatoid and Early and Arthritis is a new audit set to publish its first work toward the end of 2015. It will aim to improve the quality of care by specialist rheumatology services, including identifying areas where service improvements are required using criteria derived from NICE and Best Practice Tariffs together with patient recorded outcome and experience measures.

Cancer: Bowel cancer audit

Colorectal (large bowel) cancer is the most common cancer in non-smokers and second most common cause of death from cancer in England and Wales. Each year over 30,000 new cases are diagnosed, and bowel cancer is registered as the underlying cause of death in half of this number.

Cancer: Head and neck cancer audit

The most common sites for head and neck cancer are the larynx (throat) and oral cavity (mouth). Head and neck cancer treatment requires a wide range of expertise, and treatment is usually discussed and agreed by multidisciplinary teams (MDTs). The aim of this audit is to produce meaningful results that act as a vehicle to improve delivery of care to patients.

Cancer: Lung

Lung cancer has the highest mortality rate of all forms of cancer in the western world and there is evidence that the UK's survival rates compare poorly with those in the rest of Europe. There is also evidence that, in the UK, standards of care differ widely. The audit was set up in response to the NHS Cancer Plan, to monitor the introduction and effectiveness of cancer services.

Cancer: Oesophago-gastric (stomach) cancer audit

The Oesophago-gastric (stomach) Cancer audit aims to examine the quality of care given to patients and thereby help services to improve. The audit evaluates the process of care and the outcomes of treatment for all O-G cancer patients, both curative and palliative.

Cancer: Prostate

The National Prostate Cancer Audit will assess patient outcomes, improve clinical practice and ultimately save lives. The audit will be undertaken by a team involving the British Association of Urological Surgeons (BAUS), the British Uro-Oncology Group and the National Cancer Intelligence Network, in partnership with the Royal College of Surgeons.

COPD: Chronic obstructive pulmonary disease

The audit programme brings together primary care, secondary care, rehabilitation and patient experience, marking a ground breaking, partnership approach with multidisciplinary, collaborative working to drive improvements in COPD patient care. This new audit programme supports the Department of Health (DH) aim to improve the quality of services for people with COPD by measuring and reporting the delivery of care as defined by standards embedded in guidance.

National Audit of Dementia: Care in general hospitals

This audit is being managed by the Royal College of Psychiatrists Centre for Quality Improvement and collects information to provide feedback both nationally and locally about the quality of care received by people with dementia in general hospitals.

Diabetes: Adult

Diabetes is a chronic condition affecting over two million people in England and Wales. It is caused by an inability to use or produce the hormone insulin and leads to a rise in blood glucose. The National Diabetes Audit is considered to be the largest annual clinical audit in the world, providing an infrastructure for the collation, analysis, benchmarking and feedback of local data across the NHS.

Diabetes: Paediatric

Diabetes is a chronic condition affecting over 2 million people in England and Wales. It is caused by an inability to use or produce the hormone insulin and leads to a rise in blood glucose. The RCPCH aims to reinvigorate this high profile national audit and introduce a number of innovations and efficiencies, including measures of patient experience and the use of innovative approaches to data collection, that minimise the burden on clinicians.

Emergency laparotomy

The National Emergency Laparotomy Audit (NELA) looks at structure, process and outcome measures for the quality of care received by patients undergoing emergency laparotomy, comparing against standards of care such as those detailed by NCEPOD, the Department of Health and Royal College of Surgeons.

Falls and fragility fractures (includes the Hip Fracture Database)

The Falls and Fragility Fracture Audit Programme (FFFAP) is a national clinical audit designed to audit the care that patients with fragility fractures and inpatient falls receive in hospital and to facilitate quality improvement initiatives.

Heart: National adult cardiac surgery audit

This project looks at heart operations. Details of who does the operations, the general health of the patients, the nature and outcome of the operation, particularly mortality rates in relation to preoperative risk and major complications are all collected and analysed.

Heart: Cardiac arrhythmia (or ablation)

This project looks at activity and trends in pacing, ICD and cardiac ablation practice in UK hospitals. Details of the type of procedures performed, who the procedure is performed by, technical success of each type of procedure and outcomes including potential complications is collected and analysed.

Heart: Congenital heart disease

Congenital heart disease refers to any defect of the heart present from birth. The National Congenital Heart Disease Audit profiles every specialist congenital heart disease centre in Great Britain and Ireland, including the number and range of procedures they carry out and survival rates for the most common types of treatment.

Heart: Coronary angioplasty (PCI)

This project looks at percutaneous coronary intervention (PCI) procedures performed in the UK. The audit collects and analyses data on the nature and outcome of PCI procedures, who performs them and the general health of patients. The audit utilises the Central Cardiac Audit Database (CCAD) which has developed secure data collection, analysis and monitoring tools and provides a common infrastructure for all the coronary heart disease audits.

Heart: Heart failure

The aim of this project is to improve the quality of care for patients with heart failure through continual audit and to support the implementation of the national service framework for coronary heart disease.

Heart: Myocardial ischaemia national audit project

The Myocardial Ischaemia National Audit Project (MINAP) was established in 1999 in response to the national service framework (NSF) for coronary heart disease, to examine the quality of management of heart attacks (myocardial infarction) in hospitals in England and Wales.


MEDFASH is working with Public Health England (PHE), the British Association for Sexual Health and HIV (BASHH) and the British HIV Association (BHIVA) to conduct a one-year feasibility project exploring and evaluating the design of a future national clinical audit of healthcare for HIV, chlamydia, gonorrhoea, and syphilis.

IBD: Inflammatory bowel disease

The UK Inflammatory Bowel Disease (IBD) Audit seeks to improve the quality and safety of care for IBD patients in hospitals throughout the UK. It will do this by assessing individual patient care and service resources and organisation against the National Service Standards for the care of patients.

Intensive and special care: Neonatal

The National Neonatal Audit Programme (NNAP) was established in January 2006 in order to assess whether babies requiring neonatal care receive consistent care across England and Wales, identify areas for improvement and provide a mechanism for ensuring consistent high quality care in neonatal services.

Intensive care: Paediatric

PICANet was established in 2002 and aims to continually support the improvement of paediatric intensive care provision throughout the UK by providing detailed information on paediatric intensive care activity and outcomes.

Joint replacement surgery: the National Joint Registry

Hip, knee, ankle, elbow and shoulder joint replacements are common and highly successful operations that bring many patients relief from pain and improved mobility. More than 200,000 of these joint replacement operations take place in the UK every year. The National Joint Registry (NJR) was set up by the Department of Health and Welsh Government in 2002 to collect information on joint replacement operations and to monitor the performance of implants, hospitals and surgeons. Northern Ireland joined in February 2013 and the Isle of Man in 2015.

Kidney: Chronic kidney disease (primary care)

The National Chronic Kidney Disease (CKD) Audit’s aim is to improve the identification, management and care of CKD patients in primary care. The audit objectives are to improve the identification of CKD patients in primary care, improve the management and outcomes of CKD patients and tailor the care of people with CKD to local care pathways.

National Maternity and Perinatal Audit

Programme overview

Using timely, high quality data, the National Maternity and Perinatal Audit (NMPA) aims to evaluate a range of care processes and outcomes in order to identify good practice and areas for improvement in the care of women and babies looked after by NHS maternity services.


The project aims to prospectively collect, collate and analyse a standardised, nationally agreed cataract surgery dataset from all centres providing NHS cataract surgery in England & Wales to update benchmark standards of care and provide a powerful quality improvement tool. In addition to cataract surgery, electronic ophthalmology feasibility audits will be undertaken for glaucoma, retinal detachment surgery and age-related macular degeneration (AMD).

Stroke: Sentinel stroke national audit programme

The national sentinel audit of stroke assesses the quality of the organisation and delivery of multi-disciplinary inpatient services in England, Wales and Northern Ireland.

Specialist rehabilitation for patients with complex needs following major injury

The National Clinical Audit of Specialist Rehabilitation for Patients with Complex Needs Following Major Injury is conducted in partnership with the British Society of Rehabilitation Medicine (BSRM) and led by: The UK Rehabilitation Outcomes Collaborative (UKROC), London North West Healthcare NHS Trust, The Trauma Audit and Research Network (TARN), Manchester University, and The Cicely Saunders Institute, King’s College London. It will provide a comparative assessment of services provided  in relation to specialist injuries caused by events such as road accidents and falls etc. The main focus will be on three key areas: an audit identifying services providing care to trauma patients, an audit of complex need patients within major trauma centres, and a feasibility study for post-discharge patients who require specialist rehabilitation.

Vascular: National Vascular Registry

The National Vascular Registry (NVR) aims to improve the quality of care for patients undergoing different vascular procedures. It will examine care related to the repair of Abdominal Aortic Aneurysms, carotid endarterectomy among stroke patients, and interventions for peripheral arterial disease. The registry is run in collaboration with the Vascular Society of Great Britain and Ireland (VSGBI). It forms an essential element of their quality improvement programme and will build on the success of the National Vascular Database.