NCDs and clinical audit: the start of true engagement?
Published: 24 Nov 2015
Medical director’s blog by HQIP’s Professor Danny Keenan
Last week saw myself and NAGCAE chair Nick Black present to the monthly meeting of the National Clinical Directors in Leeds on the current and future positions for clinical audit – and I’m delighted to say the session was well received and led to real engagement and interesting debate.
I gave an overview of HQIP and our role in using audit, enquiries methodology and registries, national and locally, in promoting quality improvement, while Nick majored on the role of NAGCAE (the National Advisory Group on Clinical Audit and Enquiries, which is, of course, advisory to NHS England).
This was a vital opportunity to remind the most senior clinicians what audit is meant to achieve, what it does achieve and what we hope it can achieve going forward and I like to think we took it.
So, Nick and I looked at national audits, reminding the NCDs of those projects’ remit – to quality assess the process and/or the outcome of care; to stimulate and support quality improvement interventions and to assess the impact of such interventions.
We pointed out the steady increase in national audits, highlighted how their data supports activities relevant to everyone from patients and commissioners to managers and regulators and also how this information populates the NHS Outcomes Framework.
As a prime recent example, we looked to last year’s release of individual surgical results was only possible because of the existence of a series of national audits. As we currently prepare for the second, extended, iteration we can see that as a firm endorsement of these projects’ powerful, robust content.
That’s not to say however that the world of national clinical audit is not without its challenges so these were also key to the session. Chief among these are ensuring audits all do actively support quality improvement, and also how projects should accurately reflect the patient pathway.
On the latter point, where relevant, we see it as a priority to take national audits into primary care. And on the former point of ensuring tangible improvements we discussed how HQIP is developing a framework to assess this.
But, as we made clear to our NCD colleagues, we need buy in at NCD-level to really see that through. There will be hard work ahead, but I came away feeling positive that this was a reality we were all working towards.