Latest news: October 2025 eBulletin

30 Oct 2025

The October edition of HQIP’s eBulletin is out now! It features the latest news and updates relating to clinical audit, outcome reviews and data-informed healthcare improvement, including: What’s new?

New case study on Post-Covid care
National Clinical Audit of Perioperative Care tender outcome
Professor Danny Keenan to retire as HQIP Medical Director
HQIP’s patient advocates guide national obesity care
Job opportunities at HQIP

A chance to revisit:

Latest reports and data
The value of audit in identifying health inequalities

In other news:

Patient story showcases the value of the NJR
HQIP staff representing national clinical audit at events
Publication of the CVDPREVENT June 2025 data

Read HQIP’s latest eBulletin here.

Don’t forget to sign up: Keep up to date with our latest news, events and work programmes by subscribing to our mailing list today. You can also follow us on LinkedIn and X: @HQIP

Leadership vacancy: HQIP Medical Director

23 Oct 2025

HQIP recently announced that Professor Danny Keenan will be retiring from his role as Medical Director in the new year. Over more than a decade, Danny has played a pivotal role in advancing HQIP’s mission to drive quality improvement across the NHS through clinical audit and national registries. Find out more about his outstanding leadership and impact at HQIP and beyond in this article. We now begin the process of recruiting Danny’s successor, to ensure continuity of clinical leadership and build on the strong foundation he has established. We are seeking an outstanding Medical Director to provide senior clinical leadership across our national portfolio of clinical audits, confidential enquiries, and registries. This high-profile role will shape the way data is used to improve patient outcomes, strengthen multidisciplinary leadership, and represent the voice of clinicians and patients in national discussions. The successful candidate will work alongside our Chief Executive, Chris Gush, and the Board of Trustees to provide credible and visible clinical leadership for HQIP programmes and partners. Already having extensive national networks and credibility across the NHS and professional bodies, they will build further on these to create strong partnerships with NHS England, Department of Health and Social Care, Royal Colleges, regulators, and patient organisations. This is an exceptional opportunity for an experienced and credible clinical leader to influence national practice, champion improvement, and help shape the future of audit and registry programmes. The role is part time (two days per week) for a fixed term of three years and the closing date for applications is 11pm 30 November.

Find out more and how to apply

Reminder: NHS England Quality Accounts List 2026-27: Annual Scoping Survey

20 Oct 2025

Providers of national audits and quality improvement projects that would like to be considered for inclusion in the NHS England Quality Accounts List 2026-27 are asked to complete the scoping survey linked below by Monday 27 October 2025. (Projects commissioned by HQIP, as part of the NCAPOP, do not need to complete a scoping survey) Please complete the survey using this link. Further information can be found on the HQIP Quality Accounts webpage. Full survey url: https://www.surveymonkey.com/r/P2CQC22

Don’t forget to sign up: Keep up to date with our latest news, events and work programmes by subscribing to our mailing list today. You can also follow us on LinkedIn and X: @HQIP

NEW case study on using audit to improve Post-Covid Syndrome care

19 Oct 2025

HQIP is pleased to share a new case study from the 2025 Clinical Audit Hero Award Influencing Change runner-up, East Suffolk and North Essex NHS Foundation Trust Long Covid team in partnership with KiActiv, which showcases how they used clinical audit data to evaluate and improve Post-Covid Syndrome care.

Led by Sarah Fowler, Clinical Audit Facilitator, and a multidisciplinary team, their project assessed the effectiveness of a new digital intervention integrated into routine clinical care for patients experiencing Post-Covid Syndrome. By embedding structured evaluation metrics from the outset, it highlights how collaborative, audit-informed innovation can enhance recovery pathways, relieve pressure on traditional services, and deliver measurable value across clinical, operational and financial domains.

Download the case study: Case Study – Influencing Change Runner-Up East Suffolk and North Essex NHS FT

This case study was developed as part of Clinical Audit Awareness Week 2025 (which took place 2–6 June 2025, #CAAW25). You can explore other available #CAAW25 resources by heading over to the #CAAW25 main webpage.

Professor Danny Keenan to Retire as HQIP Medical Director

19 Oct 2025

HQIP announces that Professor Danny Keenan will be retiring from his role as HQIP Medical Director in the new year, marking the end of an extraordinary chapter in the organisation’s history.

Danny has served as HQIP’s first and only Medical Director since 2013, providing outstanding leadership, clinical insight, and an unwavering commitment to improving patient care. Over more than a decade, he has played a pivotal role in advancing HQIP’s mission to drive quality improvement across the NHS through clinical audit and national registries. Under Danny’s leadership, HQIP’s clinical programmes have become internationally recognised examples of how audit data can be used to deliver meaningful change. He has clinically led the National Clinical Audit and Patient Outcomes Programme (NCAPOP), commissioned by NHS England, which now spans over forty clinical specialties and provides critical intelligence to improve patient outcomes across the health system. Danny’s influence has been transformative. He pioneered National Clinical Audit Benchmarking, enabling NHS Trusts to measure and understand their performance, address unwarranted variation, and share learning more transparently. He has also been instrumental in positioning clinical audit as a cornerstone of healthcare improvement, fostering a culture of openness, accountability, and continual learning. His work has extended well beyond HQIP. As Clinical Director at the Manchester Heart Centre, he led one of the UK’s most advanced cardiothoracic surgery units. As an Honorary Professor of Cardiothoracic Surgery at the University of Manchester, he has mentored generations of clinicians and future healthcare leaders. Danny has also served as Clinical Advisor to the Care Quality Commission and as Chair of the Indicator Advisory Committee for NICE, helping to shape national standards and policy on outcomes and quality. Danny’s commitment to improving care has left a lasting mark on HQIP, and the NHS as a whole. His belief in the power of clinical audit to drive better care has become part of HQIP’s DNA, influencing national programmes and international practice alike. HQIP Chief Executive Chris Gush said:

“Danny’s contribution to HQIP and to the wider healthcare system has been immense. His leadership, wisdom, and passion for improvement have shaped much of what HQIP stands for today. We are deeply grateful for his service and wish him every happiness in his retirement.”

Recruiting Danny’s successor

HQIP will shortly begin the process of recruiting Danny’s successor to ensure continuity of clinical leadership and to build on the strong foundation he has established. The role description and application details for the Medical Director position will be posted on our Work With Us webpage later this week.

The right fit for patients

15 Oct 2025

How HQIP’s patient advocates are guiding national obesity care.

It’s estimated that one in four adults is currently living with obesity, a serious health condition that significantly increases the risk of type 2 diabetes, heart disease and stroke. This comes at an enormous cost that far exceeds financial implications. Living with obesity can affect quality of life, and have wide-reaching implications relating to mental health, employment and many other issues. So it’s paramount that care is effective. To achieve that, it needs to be delivered in the right way – and that’s where HQIP’s patient advocates come in…

Meet Aurora. She is a young professional working in HR & Finance in London. Nothing too unusual about that, you might think. However, thanks to Aurora – and others like her – the NHS is able to tailor its obesity prevention programme (including the use of ‘weight loss injections’) so that it better meets the needs of patients. Then, it is more likely to be successful, leading to a healthier, happier nation.

“I believe that healthcare services are stronger and more effective when they are shaped by the people who use them”

HQIP is proud to play a pivotal role in this initiative. We have long-since run a Service User Network (SUN), who support HQIP-commissioned programmes by guiding and co-creating our work. By working in partnership, HQIP and our patient advocates have built a reputation for promoting the use of plain language and accessible processes. This is how we came to establish a specific Obesity User Panel in April 2022. HQIP is a long-term partner of NHS England, and we were initially approached by them to provide patient input into a dashboard they were putting together on obesity care, to make it accessible and inclusive.

The success of this initial interaction meant that the Panel was asked to provide feedback on other aspects of NHS obesity prevention work. For example, supporting the development of an accessible user guide, to support the use of the dashboard. At first the Panel comprised of 20 patients, but this grew to 30 by 2025, following a request from NHS England to increase the numbers – due to an escalation in interest about new treatments such as ‘obesity jabs’. It also meant that we were able to better represent the wider patient community, and have more diverse experience and cultural backgrounds included in decision making.

“It’s great to know that service design will better reflect patient priorities as a result”

Aurora explains why she became involved: “I joined the Panel, after seeing an advert from HQIP asking for people with lived experience of obesity healthcare services, in the Patient Association newsletter. I was immediately interested since, at the time, there was uncertainty as to which care pathway I should follow. I began weight management around three years ago, and my experience has not always been the easiest, which showed me how important it is for the patient perspective to be heard. Every patient journey is different. Some people seek help first via A&E, and some via their GP etc but, in my experience, many go ‘around the houses’ within the system to find the help they need. I have received both Level 2 and Level 3 treatments, and tried digital weight management programmes as well as injections. But I was finding that it was very time-consuming to piece together the different aspects of my care, such as obtaining results from different departments, and linking between both the primary and secondary care systems. In short, I wanted to get involved because I believe that healthcare services are stronger and more effective when they are shaped by the people who use them.”

“There is a genuine willingness from NHS England, to adjust their plans based on what we tell them”

What does your involvement look like in practice?

“We are involved in many different things. We might be asked to share our views on proposed approaches to implementing a new provision, or our experience about access to services, and we are often asked to provide feedback into patient resources and materials. Previously, we worked together with HQIP on a response to a NICE* consultation on obesity care; while more recently, we provided input into wrap-around care. HQIP held a focus group, attended by NHS England, to understand patients’ views on the wider aspects of care such as mental health and communications etc. More generally, we participate in online meetings and focus groups, and provide one-to-one feedback via surveys and by email. For me, I always try to make the most of being involved, by asking questions and identifying potential impacts for patients.”

What are the benefits, and challenges, of being involved?

“I genuinely feel that my view is taken into account. I simply couldn’t commit the time if I didn’t feel that my voice was being listened to. I have to juggle many things to be involved as, in addition to work, I also have caring responsibilities. It’s that important to me. There is a genuine willingness from NHS England, to adjust their plans based on what we tell them. For instance, we have said that there is a need to take into account individual and cultural differences, such as dietary habits and barriers to accessing services; and NHS England is listening to this important feedback. It’s great to know that service design will better reflect patient priorities as a result.

Also, the User Panel is a really collaborative experience, we are a community. Everyone values each other’s input. When I am together with people with similar experiences, I am able to learn from them. Their insights and perspective can – and have – helped me to better understand my own condition and care. For example, I can find out about the experience of someone who is accessing services in another part of the country.”

“The User Panel is a really collaborative experience, we are a community”

“However, there are some challenges, as there are with any activity like this. Time is restricted and effort needs to be made to make sure that all voices are heard, particularly if someone has a complex medical history. Then there’s the terminology – for some, not having a great health literacy can be a challenge. But HQIP takes our needs into consideration, and makes adjustments where possible. For example, they provide information in advance about deadlines and any preparation that is needed, and they have changed the way they communicate with the whole group.”

From HQIP’s point of view, we are grateful to patient partners like Aurora, who dedicate time and energy to share insights about their care and treatment. As she has stated here – and as outlined in key government strategies such as the 10 Year Health Plan for England – patient engagement is crucial for healthcare. We are starting to see strategies that are more culturally sensitive which support tailored health interventions for communities where, for example, there may be less awareness of healthy eating habits or lifestyle changes. One important recent change is that health conditions (rather than just BMI) should inform care, with adjustments made to BMI thresholds for certain ethnic groups based on increased health risks. There’s also an acknowledgement more generally that services, public health campaigns and outreach efforts need to be more localised and culturally relevant, and involve community leaders. Only by working closely with patients and communities, can we truly understand their priorities and concerns, and deliver services that meet all of our needs.

So, what’s next for Aurora? Her weight loss journey continues, albeit temporarily halted due to unrelated surgery. However, she continues to be an invaluable asset to HQIP’s Obesity User Panel. In fact, she has since been invited to join our Service User Network (SUN), providing insights and feedback to all of our work. But what are her hopes for the future? “We need to continue to engage patients in decisions made about care, and inform them about the impact of those decisions, taking into account both the medical and social factors that patients face. I would like to see more holistic care provided, where the different services are joined up. And I would like to see everything explained clearly, in an accessible way. However, I am proud to be part of a process that will, in my opinion, lead to these changes being made. As such, I look forward to a future where obesity – indeed, all – care is realistic, compassionate and personalised.”

Further information

How HQIP engages patients
More about HQIP patient engagement and obesity
More about HQIP’s Service User Network (SUN)
NHS England obesity dashboard and guidance for the public
Article – The Power of Patient and Public Involvement (PPI) in Healthcare Improvement
Article – Patient voice in clinical audit – A powerful partnership improving asthma and COPD care
Interview – My Data, My Health: Find out what patients think about the value of data in healthcare improvement
Videos/podcasts – Real stories of Patient and Public Involvement:
- Patient advocacy in healthcare
- Shared decision-making in healthcare
Further resources on Patient and Public Involvement (PPI)

*National Institute for Health and Care Excellence (NICE)

The Power of Patient and Public Involvement (PPI) in Healthcare Improvement

9 Oct 2025

How PPI Benefits the Wider Healthcare Landscape and Can Help Tackle Health Inequalities

By Kim Rezel, Head of Patient and Carer Engagement at HQIP, and Amy Wizard Ponter, HQIP SUN member “Today, power in the health service could not be further away from its patients”, said The Rt Hon Wes Streeting MP, Health and Social Care Secretary, at NHS ConfedExpo in June 2025. Patient and Public Involvement (PPI) is an essential component of healthcare improvement. It ensures that services are designed with the people who use them, not for them, with their voices being at the heart of decision-making. The CORE20PLUS5 framework emphasises the importance of engaging patients, particularly those from under-represented groups, to drive meaningful change. By incorporating diverse perspectives, healthcare organisations can enhance transparency, inclusivity, and – ultimately – patient outcomes. This article considers some of the multitude of benefits that effective PPI can bring, how to overcome potential barriers to engagement, and examples of real-world PPI in action.

The Transformative Power of Involving People with Lived Experience

Engaging people with lived experience in healthcare must never be a tick box exercise or after-thought. When done properly, with true co-production, it has huge benefits including:

Enhancing healthcare improvement by prioritising what matters to patients: Patients bring unique insights that clinicians and healthcare professionals may not consider, helping to shape more effective and patient-centred services. Understanding the priorities and concerns of those with lived experience helps produce and deliver services and resources that bring better outcomes for patients – ultimately, what we are all trying to achieve.
Including diverse perspectives and helping tackle health inequalities: Involving individuals from various backgrounds helps to understand diverse needs of individuals and communities. This is especially important when considering healthcare inequalities and hearing from those experiencing the worst health outcomes.
Strengthening transparency and inclusivity: A more collaborative approach fosters trust and accountability within the healthcare system, providing patients and carers with knowledge and understanding to empower them to be involved. This could be in their own care, the co-design of services for everyone, or the co-production of healthcare resources.
Learning and evolving: Service users bring not only their insights, but their wide-ranging skills too. These can be utilised in all aspects of service improvement.
Working together is better for staff too: Collaboration helps to boost morale and fosters effective working towards a common goal, with staff and patients alike thereby benefiting.

Addressing Healthcare Disparities through Proactive Engagement

Health inequalities remain a significant challenge within the NHS. Men living in the most deprived areas of England die almost 10 years earlier than those in the least deprived areas, while women face a gap of nearly 8 years. The National Prostate Cancer Audit State of the Nation Report, published January 2025, highlighted how the percentage of men with high-risk/locally advanced cancer who received radical treatment showed a graded association between treatment and deprivation. Treatment rates decreased from 83.2% in the least deprived areas to 75.4% in the most deprived areas for men aged 60 to 69 years. For the period reported, black populations had more cases per 1,000 men than other ethnicities across all ages and stages at diagnosis. This was true in both ‘black or black British–African’ and ‘black or black British–Caribbean’ groups, with larger increases seen for the former group. Such disparities highlight the urgent need for targeted engagement with communities experiencing the greatest health inequalities. Proactively engaging communities ensures that the voices of those most affected by disparities are heard. By working closely with local organisations, we can design interventions that directly address specific needs, helping to bridge the health equity gap. Aligning these efforts with NHS priorities, such as CORE20PLUS5, further strengthens the impact of such initiatives.

Overcoming Barriers to Effective PPI

While the benefits of PPI are clear, challenges can hinder meaningful engagement. Here are some common barriers and strategies to overcome them:

Time constraints: Collaborate with grassroots organisations, faith groups, and cultural spaces that have existing networks within the communities you wish to reach. These groups likely have established relationships and are keen to support dissemination efforts. Do keep in mind that these organisations often operate with limited funding, so consider offering financial support for their time and expertise, or other benefits, such as helping to elevate their work.
Leverage already existing data: Drawing on information that is already out there related to your project can help inform who and where to target and how to reach varied audiences to represent diverse voices.
Budget limitations: Start small and remember that delivering the right service from the outset can prevent wasted resources in the long-term. Financial incentives for involvement do have their place, but a ‘thank you’ payment must align with your organisational budget – being clear on the incentives that you can offer from the outset is key. Set out what being involved can mean for the patient, whether it’s learning and development, participating in change, and/or financial.
Champion the PPI voice: Effectively conveying the value of the input people have, such as demonstrating meaningful change or showing what they have directly impacted, can be a key driver for engagement.
Tap into what really matters: Consider your project priorities; if these are in line with what resonates with diverse people and communities, then they will want to be involved.
Use their work and input: Co-authorship, co-design and co-production! Showing the value of someone’s work and input is great for morale and shows that a difference is being made.
Public awareness: Utilise trusted spaces, such as GP surgeries, faith communities, community centres, and social media, to share information and engagement opportunities.
Cultural competency: Collaborate with local/community organisations to ensure staff are trained to engage with diverse communities in culturally sensitive ways.
Accessibility: Offer multiple engagement methods, including virtual sessions, in-person meetings, and arts-based approaches. Be flexible too – allow people different ways to be involved, giving them choice and control.
Offer additional benefits: Incentivise people by offering things like training, enabling them to add skills to their CV and giving them an extra reason to participate.
Encourage ideas and creativity: This galvanises people to be included and to see that their priorities are being taken seriously.
Disseminate effectively: Whether you wish to create knowledge about your project itself or get the word out that you are seeking to involve more people and communities, work with your public voices to create and use the best approaches to achieve multiple positive benefits and outcomes.
Equity and value: This is essential. Participation from patient advocates is just as important as participation from clinicians and healthcare professionals, so they must be treated as equals. This leads to longer-term loyalty and commitment, building of good working relationships and establishing trust.

“I’m an expert by experience, just like the rest of the table are experts in their field. My time and input are worth no less than theirs.” Meg, SUN member

PPI in action: Shaping improved outcomes

At HQIP, we have seen first-hand how PPI can improve outcomes. Our National Clinical Audit and Patient Outcomes Programme (NCAPOP) projects undergo continuous improvements, with their outputs and outcomes enhanced through collaborating with, and listening to, their patient advocates. Let’s look at some examples of excellent PPI that demonstrate how to drive inclusivity and widen the pool of those able and willing to contribute.

Epilepsy 12 National Audit

The Epilepsy 12 team collaborate with a group of Youth Advocates (YA), not only to hear their views of epilepsy care but also to empower them to contribute to the way the audit is run. Based on the YA engagement, the audit’s dataset evolved to include the monitoring of mental health, impact on education, and transition from children’s to adults’ epilepsy services – priorities raised by the YA and epilepsy charities that partner in the project. Work is driven by the YA collective voice, which makes for better PPI, giving validity and merit to the ideas, innovations, and motivations of those getting involved in quality improvements. A key aspect of the success of the group has been open and flexible engagement. YA have the control – they choose when and how they are involved. This actually encourages longer-term commitment, as the YA are not signed up for a set time period, reducing pressure on them. The young people also mutually benefit, not only from their involvement and impact on actual change, but also by developing their confidence, leadership, and other skills. It is important to ensure benefits on both sides in any PPI – and if that can extend beyond the direct service improvement, it not only encourages existing participants to become further involved but also helps inspire other young people to join the work too. One YA shared: “The impact for me has been seeing how it started off so small with a few clinics, to how well known it is now nationwide. We’re helping so many patients and families.”

National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH)

The Mental Health Clinical Outcome Review Programme, delivered by the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) and commissioned by HQIP, has been collecting information on suicides since 1996. Looking at the circumstances leading up to a person’s suicide, and any factors which may be related to management of the person’s care over decades, have led to important recommendations that make a difference to suicide rates through care improvements. Taking into consideration numerous findings from various primary and secondary care resources, they have created clinical standards based on real-world data. NCISH work actively with PPI, truly establishing the views of many in all aspects of their vital work. They collaborate with the Mutual Support for Mental Health PPI group; people with personal experience of self-harm, suicidal behaviour, or mental illness, or of caring for people with such experiences. This collaboration enables NCISH to inform recommendations through PPI input, develop new areas of work based on service user priorities, and make care safer through developing research. PPI also guides them when creating resources, and when considering communication approaches and how to disseminate outputs most effectively. Some of the changes they have implemented are shown in this image:

Listening to marginalised voices in maternity

In an HQIP project commissioned by NHS England to inform the development of an inclusive Patient-Reported Experience Measure for maternity care, we engaged with seldom heard communities about their experiences. Rather than repeating engagement processes that had already been conducted, we leveraged existing research and spoke to organisations who had already connected with affected communities. Collaborating with community networks and organisations is an important step to learning and building relationships. It eases pressure on your resources, saves funding, and promotes smaller organisations. Yet, it is also an excellent way to truly find the information and data that you need with those who may be more ‘on the ground’ than you are able to be. Find out more about how this approach uncovered fresh insights and the impact the project had in this case study.

Final reflections

True healthcare improvement requires the voices of those who experience the system first-hand. PPI is not just a policy requirement or a ‘nice to have’ – it is a powerful tool for designing services that are truly patient-centred. It is at the core of driving meaningful change; it is both an expectation and need across all healthcare. There are a multitude of ways to utilise PPI so that it is beneficial for all, staff and patients alike. By actively engaging with all communities, overcoming any barriers and working collaboratively, we can ensure that healthcare services are equitable, effective and aligned with the needs of the people they serve. With the challenges the NHS currently faces and a widely understood need for transformation and improvement, as articulated by the NHS 10 Year Plan for England, meaningful patient and public engagement has perhaps never been more essential. With thanks to Amy Wizard Ponter, HQIP SUN member, for co-authoring this article.

New resources published October 2025

9 Oct 2025

We are pleased to announce that the following NEW RESOURCES to support quality improvement in healthcare (reports with data, findings, infographics and recommendations), from HQIP-commissioned audits and programmes, have been published:

Respiratory care – clinical outcomes and outlier report, National Respiratory Audit Programme (NRAP). With key findings in relation to mortality and readmissions, this report can be used by service providers, commissioners and clinical teams to identify areas of success or those requiring improvement to facilitate and influence change.
Neonatal care – summary report 2024 data, National Neonatal Audit Programme (NNAP). Includes a number of key findings, as well as recommendations, for improvement on a range of areas including parental partnership, equity, and neonatal nurse staffing.
Rheumatic diseases – State of the Nation 2025, National Early Inflammatory Arthritis Audit (NEIAA). In addition to key findings, this report includes an exemplar case study and five recommendations for improvement.
Inpatient falls – Stepping towards improvement, National Audit of Inpatient Falls (NAIF), part of the Falls and Fragility Fractures Audit Programme (FFFAP). Introduces, for the first time, statistics that describe the age, sex and multiple deprivation of patients.
Emergency laparotomy – tenth patient report, National Emergency Laparotomy Audit (NELA). Found evidence of wide variation between hospitals in both processes and outcomes of care, and so contains suggestions for quality improvement (QI) as well as recommendations for Royal Colleges and healthcare commissioners.
Blood sodium report, Medical and Surgical Outcome Review Programme (NCEPOD). States that care and outcomes can be improved through timely and appropriate identification and investigation, consistent recording, and effective communication.
Prostate cancer – State of the Nation report, National Prostate Cancer Audit (NPCA), part of the National Cancer Audit Collaborating Centre (NATCAN). Found that there was wide variation in the use of appropriate treatment between different hospitals.
Bowel cancer – State of the Nation report, National Bowel Cancer Audit (NBOCA), part of the National Cancer Audit Collaborating Centre (NATCAN). The proportion of people diagnosed with stage 1 or 2 bowel cancer has gradually increased, while peri-operative outcomes continue to improve.

Further data

In addition, we are pleased to share that the following data is also available this month:

Stroke care – Sentinel Stroke National Audit Programme (SSNAP), April-June 2025 data and Organisational Audit portfolio May 2025
Mental health – National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH), latest quarterly data
Cancer – National Cancer Audit Collaborating Centre (NATCAN), latest quarterly data on:
- Primary breast cancer
- Metastatic breast cancer
- Ovarian cancer
- Pancreatic cancer
- Non-Hodgkin lymphoma
- Kidney cancer
- Oesophagogastric cancer
- Lung cancer
- Bowel cancer
- Prostate cancer.

All reports: All HQIP-commissioned reports can be accessed via our dedicated reports webpage. Stay up to date: Join our mailing list to receive notifications when new reports are published.

Using data to maximise resources

4 Oct 2025

How National Clinical Audit Supports System Level Priorities.

Healthcare data highlights the changes that will have the greatest impact on services and patient outcomes. It is critical in ‘lighting the way’ for system leaders, to understand where to target resources to deliver improvements, particularly in these changing times when pressures have never been greater. HQIP’s CEO, Chris Gush, explains how national clinical audit helps Integrated Care Systems (ICSs) and other healthcare leaders to maximise resources and deliver their priorities.

Integrated Care Systems (ICSs) – through their Integrated Care Boards (ICBs) – were established to improve population health, enhancing productivity and value, and supporting broader social improvements such as reducing health inequalities. In other words, support the NHS to pursue ambitious goals for better care.

As we all now know, the NHS in England is changing. However, the aspiration to deliver improved care and outcomes for patients remains. If anything, it is now more important than ever. NHS England’s functions are being absorbed into the Department of Health and Social Care (DHSC), and ICBs have been tasked with drastically cutting both their management costs and workforce. Leaders acknowledge the need to eliminate duplication and stabilise finances, but there is widespread concern that such steep cuts “will inevitably make the task of delivering long term transformation of the NHS much harder”, to quote Matthew Taylor, Chief Executive of NHS Confederation.

The aspiration to deliver improved care and outcomes for patients…is now more important than ever

Harder it may be, but data makes it feasible. The NHS has invested for decades in national clinical audits and registries that systematically track the quality of care across a broad range of services. These programs (encompassing dozens of medical, surgical, and mental health conditions) generate a wealth of information that is already collected and ready to use. In light of the current push to reduce costs – leaving far fewer hands available for analysing data – they are, in fact, an invaluable resource in the drive for transformation.

That’s where the National Clinical Audit and Patient Outcomes Programme (NCAPOP), the largest programme of its kind in the UK, plays a vital role. Commissioned by HQIP, it generates trusted, clinically validated data across the NHS. National audit data are robust and published openly, and so inform clinical guidelines, regulatory oversight, and commissioning decisions. In other words, the comparative insights from audits are a built-in evidence base for what is working well and what isn’t. Over the years, such high-quality comparative data have proven to be a stimulus for real and meaningful improvement in patient care, driving changes in practice that have saved and improved lives.

In an era of tightening resources, data becomes a force-multiplier: turning raw numbers into actionable insights

Crucially, tapping into this data doesn’t require additional local manpower to gather new information; it leverages existing intelligence to guide action. For NHS leadership, whether in an ICB boardroom, a DHSC office, or a hospital executive team, the importance of maximising this existing data asset cannot be overstated. In an era of tightening resources, data becomes a force-multiplier: turning raw numbers into actionable insights is one way to effectively “add” capacity without adding staff. National clinical audits and registries, in particular, offer an arsenal of knowledge to support system-wide learning, service transformation, and quality improvement. By making national clinical audit and registry data central to their strategy, system leaders can continue to deliver improvements despite limited capacity. Used to its fullest potential, this data can help health systems to:

Pinpoint unwarranted variation – identifying differences in outcomes or care quality across an ICS, so leaders know where to focus attention (for example, spotlighting a service or population group that is falling behind the national benchmarks).
Highlight best practices – revealing which Trust or locality is excelling in a particular domain, so that successful approaches can be shared and scaled up across other parts of the system.
Inform strategic planning and investment – providing hard evidence of needs and what works, thereby guiding ICBs in prioritising initiatives (and making the case to allocate resources where they will have the greatest impact on quality and equity).
Track improvement over time – enabling leaders to measure the results of interventions and service changes through objective outcomes data, ensuring accountability and learning as the system evolves.

By harnessing this wealth of information, ICS and ICB leaders can exercise informed system leadership, targeting interventions that make a difference even when manpower and money are limited. It means that despite the challenges of reorganisation and austerity, the NHS can continue to innovate and improve care, using evidence as its guide and data as a catalyst for delivering on ICS and ICB priorities. So, in specific terms, how can HQIP’s NCAPOP data be harnessed to support key ICB and ICS priorities?

1. Driving Quality Improvement Across Systems

One of the core responsibilities of ICBs is to coordinate quality improvement at scale. National audits provide a powerful platform for this.

Take the Sentinel Stroke National Audit Programme (SSNAP) its ICB-level performance dashboards offer system leaders a bird’s-eye view of stroke care across all local providers. Armed with this insight, ICBs can convene collaborative improvement efforts, target underperforming areas, and share current best practice across Trusts.

Similarly, CVDPREVENT, which focuses on cardiovascular disease prevention, enables comparison of risk factor management and treatment coverage across general practices, primary care networks, and places. This supports system-level interventions that improve outcomes not just in one GP practice, but across entire localities.

By aligning providers around shared outcomes and a single evidence base, audit data gives ICS leaders the foundation to drive real, sustained improvement across complex care pathways.

2. Tackling Health Inequalities with Data That Shows Where to Act

Reducing health inequalities is at the heart of the ICS mission – and national audit data offers a uniquely valuable lens into where disparities exist.

Audit reports often reveal variation in access to services, quality of care, or outcomes across demographic groups, local geographies or levels of deprivation. This kind of data is essential for identifying where action is needed, whether that’s improving rehabilitation access in underserved communities or addressing differential outcomes in chronic disease management.

By offering granular, real-world data, NCAPOP audits enable ICBs to monitor inequalities at population level, target resources, and track the impact of interventions over time. This directly supports the Core20PLUS5 framework and other system-level health equity initiatives.

3. Strengthening Oversight and Assurance

ICBs are responsible for the performance and safety of the services they commission. National clinical audits bring credibility and transparency to these oversight functions.

Audits such as the National Emergency Laparotomy Audit (NELA) and SSNAP provide comparative, risk-adjusted outcome data and benchmarking tools. These can be used in quality committees, system performance meetings, and provider assurance frameworks.

Recent NELA reports, however, highlight a plateau in some key care standards and outcomes, including 30-day mortality and time to theatre, reinforcing the need for renewed focus on improving emergency surgical pathways.

In particular, audit outlier alerts, generated when providers consistently underperform against national standards, offer early warnings and opportunities for supportive intervention. They also provide a consistent framework for celebrating excellence, understanding variation, and driving accountability in a constructive, evidence-based way.

4. Informing Outcomes-Based Commissioning

As the NHS shifts towards outcomes-based commissioning, ICBs need reliable measures to define what good looks like and to track whether services are delivering meaningful results for patients.

National clinical audits provide exactly that. For example, the National Diabetes Audit (NDA) publishes ICB-level data on key care processes and outcomes, from HbA1c control to diabetic foot complications. This allows ICBs to build commissioning strategies that incentivise better outcomes, not just activity.

Audit findings can also be incorporated into service specifications, evaluation frameworks, or population health investment decisions, enabling leaders to commission with confidence, based on what actually works.

5. Enhancing Population Health Intelligence

Integrated care systems are expected to understand and improve the health of their populations, and this requires rich, longitudinal data.

Audit programmes like CVDPREVENT contribute to this intelligence by aggregating data across primary and secondary care, enabling systems to see where the biggest risks, gaps and opportunities lie in long-term condition management.

Whether it’s identifying communities with uncontrolled hypertension, mapping variation in cancer staging, or planning dialysis services using renal audit data, NCAPOP programmes help give ICSs a 360-degree view of their population’s health needs and outcomes. When combined with demographic and social data, this becomes a powerful platform for prevention, pathway redesign, and place-based planning.

6. Supporting Service Transformation with Evidence

Transforming services at system level, whether centralising specialist care, introducing new models, or improving access, requires a solid evidence base.

National audits provide that evidence. They often identify where current practices are falling short, highlight what ‘good’ looks like, and make the case for change. For instance, audit data may demonstrate that survival rates improve when services are consolidated, or that certain interventions need to be delivered earlier in the pathway.

Audit evidence has been used to inform service redesign across stroke, vascular surgery, mental health and more, helping ICSs design pathways that are safer, more effective, and more equitable.

Turning data into improvement

The availability of data is just one part of the solution to delivering these priorities. At HQIP, we understand that integrated care leaders need more than data; they need insights that are timely, relevant, and aligned to their priorities. That is why we are working in partnership with those involved in system-level improvement to:

Publish more ICB- and place-level breakdowns
Support access to audit data for population health analytics
Make our outputs easy to interpret and apply in commissioning and transformation planning
Listen to system leaders about which topics matter most.

In this way, we are ensuring that national programmes serve local, regional and system needs, and the resultant insights support the decisions you are making every day to improve care.

How to get started – help is at hand

Whether you are designing a transformation programme, refreshing your ICS five-year plan, or seeking assurance on provider performance – HQIP and the NCAPOP can support you. Explore how our national clinical audits and wider quality improvement resources can support your system goals. Connect with us to ensure future programmes meet your evolving needs, and support long-term transformation and equity in healthcare. Together, we can turn data into insights; insights into action; and action into better care for the patients we serve.

More information:

For access to HQIP-commissioned, national clinical audits, reports and data: hqip.org.uk
For information about HQIP’s services to support evidence-informed quality improvement: hqip.org.uk/services

First perioperative care audit launched

3 Oct 2025

HQIP is pleased to share details of a new audit, the National Clinical Audit of Perioperative Care (NCAPC), which will be delivered by the Royal College of Anaesthetists (RCoA).

Perioperative care refers to patient-centred, multidisciplinary and integrated care from the point of consideration of surgery through to full recovery. The NCAPC aims to reduce unwarranted deviation from evidence-based practice in the perioperative pathway, and thereby reduce complications and increase patients’ health-related quality of life. With circa 3.5 million surgical procedures carried out in England and Wales each year, this audit (the first in this field) marks an important step in HQIP’s vision to improve health outcomes for everyone through evidence-driven healthcare.

HQIP has commissioned the Royal College of Anaesthetists to deliver the NCAPC from October 2025, with the first year being used to design the optimal methodology to audit care.

Further information can be found here.

HQIP-hosted Joint Registry supports patients to “get life back”

3 Oct 2025

A recent article in The Telegraph has highlighted the positive impact of the National Joint Registry (NJR), which is hosted by HQIP, on patients’ lives.

The article features Philip, a member of the NJR Patient Network, who shared his joint surgery experience, and how NJR resources supported him: “I did some of my own research and joined the National Joint Registry (NJR), which has a lot of very useful information and patient outcomes – the NJR is a really helpful source of hard statistics.”

In the article, he describes how the Registry helped him to make informed choices. Since his surgery, Philip has returned to kayaking and gained his active life back.

Read the full article here.

More about the National Joint Registry.