HQIP's NHS Boards survey results: real progress, much to be done

The Healthcare Quality Improvement Partnership unveils results ‘Improving the quality of patient care: are NHS Boards engaging with clinical audit?'

While NHS Boards are now significantly more involved with clinical audit-driven quality improvement, considerable room for improvement remains, according to a survey published today by the Healthcare Quality Improvement Partnership (HQIP).

HQIP - an independent body funded by the Department of Health and led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and patient representative group National Voices - exists to promote quality improvement, in particular via the impact of clinical audit has in England and Wales.

Board-level engagement with the clinical audit process has been continually championed by the Department of Health and increased engagement between management and clinicians forms one of HQIP's main targets for 2010.

Improving the quality of patient care: are NHS Boards engaging with clinical audit? questioned 110 senior clinical audit staff to ascertain if the number of clinical audits carried out by NHS organisations had increased in the last year, whether Board-level engagement with those audits had increased and, crucially, whether the quality of that interaction between management and clinicians had improved.

The results show a marked increase in the amount of clinical audits being carried out across the UK, and a significant increase in Board-level involvement. However, serious questions are raised regarding the quality of that interaction between management and the audit community - some 62% of respondents marked 'poor' or 'needs improvement' when asked about this interaction.

On a more positive note, 45% of respondents have seen the amount of Board-level engagement increase and 80% report that some form of formal review of the audit programme is in place. Some 67% said review and implementation had improved in the last 12 months.

The report's launch follows the Audit Commission's 2009 study ‘Taking it on Trust', which found that "few trusts could set out how clinical audit was being used in a systematic way to address risks".

This is the latest part of HQIP's NHS Boards engagement strategy: already this year HQIP has published Clinical audit: A simple guide for NHS Boards and partners. Written for HQIP by Dr John Bullivant and Andrew Corbett-Nolan of the Good Governance Institute, the free guide sets out why it is vital for boards to own governance of clinical care and the central role of clinical audit in helping them do so.

The next part of the HQIP/NHS Boards strategy is a consultancy event at Manchester's The Place Hotel on April 13 2010, which will see up to 50 NHS Board members meet to discuss the next steps to increase the effectiveness of clinical audit involvement at board level.

A similar event is being planned for London later this year - those interested should contact communications@hqip.org.uk to secure a place.

Improving the quality of patient care: are NHS Boards engaging with clinical audit?

Statistical highlights:

·         110 respondees

·         60% have seen an increase in the amount of clinical audits in the last year

·         88% now run both national and local clinical audit programmes

·         45% have seen the amount of Board-level engagement increase in the last 12 months (55% remained static)

·         Regarding the quality of Board-level interaction, 11% marked 'poor' and 51% marked 'needs improvement'

·         65% are happy with training and support provided by management for the clinical audit community

·         80% agree that Boards are making serious efforts to back auditors in reviewing audit results implementing change

·         Some 67% said review and implementation had improved in the last 12 months

FULL RESULTS (rounded to the nearest half percentage point):

Q: In the last 12 months, has the number of local and/or national clinical audits your Trust participated in increased, decreased or remained static?

Increased: 60%

Decreased: 3%

Remained static: 37%

Q: Does your Trust now have a clinical audit programme related to both local and national priorities, with the overall main aim of improving patient outcomes?

Local only: 6%

National only: 4%

Both: 88%

Neither: 2%

Q: In your opinion, how would you currently describe Board-level engagement with the clinical audit strategy at your Trust?

Poor: 11%

Needs improvement: 51%

Acceptable: 24%

Above average: 13%

Excellent: 1%

Q: In your opinion, do you feel the amount of Board-level engagement with the clinical audit strategy at your Trust has increased in the last 12 months?

Yes: 45%

No/Remained static: 55%

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