Integrating clinical audit and quality improvement to deliver impact for patients

1 Feb 2026

HQIP Associate Director, Dr Iain Smith, features in BMJ Leader Blog this month, on the subject of integrating clinical audit and quality improvement to deliver impact for patients…

“Fit-for-the-Future, the ten-year plan for the English NHS, envisages a focus on quality and improvement driven by data.¹ The plan acknowledges the wealth of data available nationally – including through clinical audits.¹ Furthermore, new best practice guidance from NHS England argues for clinical audit contributing to a wider quality management approach.²

Data are critical to both quality improvement and quality assurance. When used effectively, data enable organisations to demonstrate measurable improvement at both the individual project and whole organisation level.” Samantha Riley, Director of Making Data Count, NHS England

Historically, clinical audit is one of the main mechanisms for improvement in healthcare and is closely associated with quality assurance. More recently, approaches to quality improvement have been adopted into healthcare from other industries focussing on small-scale tests of change and learning – typically with measurement as a key element.³ Whilst tensions between clinical audit and other quality improvement approaches have been observed, both can work in synergy and clinical audit can play a key role in moving towards more systematic data driven quality management.^{2 4}

Background: Clinical Audit and Quality Management

Continuous improvement is a long pursued goal in healthcare.⁵ A long standing approach to improvement is clinical audit. Clinical audit involves assessing services against evidence-based criteria and is considered the foundation of a well-functioning healthcare system. It is a cyclical approach that provides feedback upon which action can be taking on areas for improvement before re-auditing to assess the impact (see Figure 1 below).^{2 6 7}

Improvement efforts are more impactful when part of a systematic approach.^{8 9} Quality management systems (QMS) are a means of systematically improving healthcare and embedding continuous improvement. A QMS combines a systematic approach to quality improvement (QI) with quality planning and quality control.^9-11 Quality planning refers to how an organisation or system identifies its priorities for improvement and designs interventions to deliver them.¹⁰ Quality planning ensures close alignment of improvement activity with the strategic objectives of the organisation or system.^{10 11} Quality control refers to measurement of processes to monitor performance in real time and taking action to deliver results in line with performance standards.^{10 11} In addition to these three core components of a QMS, in healthcare a fourth component is included. Quality assurance focuses on checking whether a service is meeting required standards based on external requirements.^{9 11} Clinical audit can play a key role across such systematic approaches.¹²

Figure 1 – The Clinical Audit Cycle (HQIP 2020, used with permission)

Clinical Audit and Quality Planning: Identifying opportunities for improvement

Clinical audit can support progress on national healthcare priorities by considering findings in planning activities. Clinical audit can contribute insights to service planning and commissioning processes by providing both cross-sectional benchmarking and longitudinal data.^{1 2} The national clinical audit and outcomes programme (NCAPOP) is one of the largest national audit programmes of its kind and can play a major role in the planning process and identification of improvement priorities.¹² If healthcare priorities are to be evidence-based, clinically credible and focused on what matters most to patients, this data should shape how services are designed and inform which improvement priorities are selected. For example, the national mothers and babies audit (MBRRACE-UK) identified persistent inequalities in maternal and perinatal outcomes linked to ethnicity, deprivation, and geography. These findings enabled providers, commissioners and national bodies to prioritise targeted improvement efforts focussing attention on highest risk groups.^{13 14}

Clinical Audit and Quality Improvement: Improving patient care and outcomes

Clinical audit is a quality improvement process that seeks to improve patient care and outcomes. A long-standing approach that has stood the test of time, clinical audit can continue to play a leading role in improving processes and outcomes nationally and locally. Through assessment against evidence-based standards for the structure, processes and outcomes of care, changes can be implemented where indicated and monitored to confirm improvement.⁷ Clinical audit also works alongside other popular approaches to QI – such as Lean and the Model-for-Improvement. These approaches support experimentation and testing in the ‘implementing change’ stage of the audit cycle.⁴ Therefore, if we want improvement that is data-driven, evidence-informed and clinically trusted, clinical audit should be central to any systematic QI approach. For example, the fragility fracture and falls audit programme (FFFAP) provides the national audit of inpatient falls (NAIF) which has seen improvements in its key indicators over the past six years. NAIF also provides resources to support local quality improvement projects.¹⁵

Clinical Audit and Quality Control: Ongoing measurement of quality

Clinical audit supports quality control processes by providing evidence of impact of changes introduced. In improvement work, to assess tests of change, a family of metrics is used comprising process and outcome measures.³ Audit is ideally placed to contribute to this and help improvement efforts to know whether changes lead to improvement. Whilst audits have been carried out previously at distal points in time, such as annually, there are examples of audits operating more frequently. With increasing focus on digital technologies, further shifts towards real-time audit are anticipated.¹ For example, the paediatric intensive care audit network (PICANet) provides continuous, risk-adjusted monitoring of outcomes, allowing providers and national bodies to track trends in mortality, detect variation and identify emerging quality concerns.¹⁶

Clinical Audit and Quality Assurance: Evidence based compliance with standards

Quality assurance processes help organisations to understand care quality through periodic checks that particular standards are being achieved and addressing identified shortfalls.^{2 11} Alongside inspection and accreditation, clinical audit is one of the main quality assurance mechanisms used by healthcare organisations.^{4 11} Clinical audit is effective for providing assurance of compliance with evidence-based standards – including national standards via national audits.

Clinical audit is one of the earliest forms of QI in healthcare. Whilst typically associated with quality assurance, clinical audit can play a key role across all quality management domains including planning, control and improvement. To provide confidence that care is consistently safe, effective and improving over time, clinical audit should underpin how we improve and monitor for proactive oversight and quality control.”

This article was published as a blog on BMJ Leader on 9th Feb 2026: Quality management and clinical audit: Integrating clinical audit and quality improvement to deliver impact for patients. By Iain Smith – The official blog of BMJ Leader

Further resources from HQIP

Discover more about how HQIP supports organisations to use clinical audit and healthcare data to drive improvement – from strategy development to implementation or training
Guidance and other resources to support improvement
Reports and infographics
Benchmarked results, searchable by project name, trust, hospital or unit

References

Department of Health & Social Care and NHS England. Fit for the future: 10 Year Health Plan for England. London: UK Government, 2025.
NHS England. Clinical audits and registries: A best practice guide. London: NHS England (Available at https://future.nhs.uk ), 2026.
Shah A. Using data for improvement. BMJ 2019;364:l189. doi: https://doi.org/10.1136/bmj.l189
Backhouse A, Ogunlayi F. Quality improvement into practice. BMJ 2020;368:m865. doi: https://doi.org/10.1136/bmj.m865
Berwick D. Continuous Improvement as an Ideal in Healthcare. New Engl J Med 1989;320(1):53-56. doi: https://doi.org/10.1056/nejm198901053200110
Ivers N, Foy R. Audit, Feedback, and Behaviour Change. Cambridge: Cambridge University Press, 2025.
HQIP. Best practice in clinical audit. London: Healthcare Quality Improvement Partnership (Available at www.hqip.org.uk ), 2020.
Dixon-Woods M, Martin GP. Does quality improvement improve quality? Future Hospital Journal 2016;3(3):191-94. doi: https://doi.org/10.7861/futurehosp.3-3-191
Spela Godec MH, John Illingworth, Carl Macrae. Developing whole-organisation Quality Management Systems in health care: learning from practice and recommendations for progress. London: The Health Foundation, 2025.
Glassborow R. Moving from Quality Improvement to Quality Management: Supporting better quality health and social care for everyone in Scotland. Edinburgh, UK: Healthcare Improvement Scotland (Available at www.ihub.scot ), 2022.
Shah A. How to move beyond quality improvement projects. BMJ 2020;370:m2319. doi: https://doi.org/10.1136/bmj.m2319
Clark CI. Healthcare data: The key to improvement and efficiency [Blog]. London: BMJ Leader; 2025 [updated 03 Dec 2025. Available from: https://blogs.bmj.com/bmjleader/2025/12/03/healthcare-data-the-key-to-improvement-and-efficiency-by-dame-celia-ingham-clark accessed 19 Jan 2026 2026.
MBRRACE-UK. Maternal mortality 2022-2024 Oxford: National Perinatal Epidemiology Unit; 2026 [updated 15 Jan 202627 Jan 2026]. Available from: https://www.npeu.ox.ac.uk/mbrrace-uk/data-brief/maternal-mortality-2022-2024.
NHS England. The Maternal Care Bundle: A care bundle for reducing maternal mortality and morbidity London: NHS England; 2026 [updated 16 Jan 2026. Available from: https://www.england.nhs.uk/long-read/the-maternal-care-bundle/ accessed 26 Jan 2026.
National Audit of Inpatient Falls (NAIF). Stepping towards improvement: an analysis of 2024 inpatient falls audit data and reflection on 6 years as continuous audit. London: Royal College of Physicians (Available at https://www.rcp.ac.uk/86396 ), 2025.
Universities of Leeds and Leicester. The Paediatric Intensive Care Audit Network (PICANet): PICANet; 2026 [Available from: https://www.picanet.org.uk accessed 27 Jan 2026.

When Every Day Matters

12 Jan 2026

HQIP Audit Drives Earlier Lung Cancer Diagnosis.

Lung cancer is one of the most significant challenges facing the NHS, representing the leading cause of cancer death in the UK. But HQIP-commissioned data released in 2025 highlights a particularly encouraging trend of lives being extended and saved: a sustained increase in the proportion of patients diagnosed at stage 1 or stage 2, when the disease is most amenable to curative treatment.

Over the past decade, the National Lung Cancer Audit (NLCA), which is commissioned by HQIP and part of the National Cancer Audit Collaborating Centre (NATCAN), has played a pivotal role in driving improvements in lung cancer diagnosis and survival. Its 2025 State of the Nation report is an audit of the NHS care received by people diagnosed with lung cancer in England and Wales during 2023. Importantly, we have seen a 7-percentage point increase in England in people diagnosed with stage 1 or 2 in 2023 (37%, up from 30% in 2021). In Wales, there’s even greater improvement, with a 10-percentage point increase (up to 34%, from 24% in 2021).

Early-stage diagnosis is fundamental to improving survival. Historically, most lung cancer cases were identified at advanced stages, limiting treatment options. Through systematic audit, benchmarking, and recommendations, identifying unwarranted variation, and providing actionable insights, the NLCA is helping to shift this pattern.

This improvement in early diagnosis aligns directly with UK healthcare priorities. The NHS 10-year plan, which highlighted that cancer outcomes in England lag behind other countries, aspires to shift the NHS from a service primarily focused on sickness to one that prioritises prevention and early diagnosis. HQIP-commissioned NATCAN, part of the Clinical Effectiveness Unit in London (a collaboration between the Royal College of Surgeons of England and the London School of Hygiene and Tropical Medicine), has a crucial role to play here. The national centre of excellence has brought all NHS national cancer audits together under one umbrella and is shining a spotlight on the care and treatment of patients who are diagnosed with cancer in England and Wales.

No progress whatsoever was made in diagnosing cancer at stage I and II between 2013 and 2021. Since then, rates have risen… with notable improvements in the early detection of lung cancer due to the targeted lung check programme.” Lord Darzi, Independent Investigation of the NHS in England, 2024

Treatment and waiting times: A mixed picture

Even with earlier diagnosis, improved patient outcomes depend heavily on timely and effective treatment. And here the picture is mixed.

People with stage 1 or 2 non-small cell lung cancer (NSCLC) in addition to a good performance status (0-2) are candidates for treatments with curative intent. The proportion of this group who had curative treatment was 80% across the whole of England in 2023, meeting the expected standard set by the audit. The proportion of people with NSCLC who had surgery also met the audit standard and exceeded pre-pandemic levels. In England, 7,018 people had lung cancer operations in 2023, an increase from 5,865 people in 2022. The audit also shows individual results for each hospital. Through these benchmarks, it helps to reduce unwarranted variation and ensure that all patients have equitable access to potentially curative treatment.

The NLCA does, however, highlight a need for improved uptake of systemic anti-cancer therapy (SACT). Clinical trials have demonstrated that SACT can transform patient outcomes for people with advanced NSCLC – extending survival, as well as improving cancer related symptoms and quality of life. In 2017, the NLCA set a standard that at of people with advanced NSCLC (stages 3B-4) and a good performance status (0-1) should receive SACT; yet the proportion who received SACT in 2023 was 62% in England. As well as being too low, this has also remained largely static in recent years

This is where clinical audits, like those in the National Clinical Audit and Patient Outcomes Programme commissioned by HQIP, make a real difference. By identifying areas for improvement and robustly monitoring progress against these, they help ensure that every patient gets the best possible treatment.

Lung cancer treatment waiting times also show cause for concern, particularly given that earlier diagnosis means demand is increasing. Delays in accessing treatment heighten stress and uncertainty for patients and, in some cases, allow the cancer to advance, limiting the effectiveness of potential treatments.

The National Optimal Lung Cancer Pathway for England (NOLCP) states that time from referral to the start of treatment for people with NSCLC should be no longer than . However, time to surgery exceeded 49 days for seven out of eight people with NSCLC at stage 1 or 2 in England, with a median time of 83 days. In Wales it was longer still, with the median time to surgery 97 days for these patients.

Timely diagnosis and treatment for people with Small Cell Lung Cancer (SCLC) is imperative too, as these tumours are highly aggressive, rapidly progressive, and can quickly spread, ultimately leading to fatal outcomes. In 2017, the NLCA set a standard that at least 80% of people with SCLC should receive SACT within 14 days of pathological diagnosis. The NLCA’s 2025 report highlights that in 2023, the median time from diagnosis to treatment in England was 15 days – with only 48% starting treatment within the target timeframe of 14 days.

It is in precisely situations like this that national clinical audit has an important role to play, working with the sector to provide evidence that highlights where changes would have an impact on patient outcomes. This will hopefully help deliver future treatment improvements, following the progress already made on earlier diagnosis.

Despite the mixed picture on treatment, crucially, more lives are being extended and saved. 2025’s NLCA report sees the median survival of the 18,653 patients in England diagnosed between 1 January and 30 June 2023 reach 358 days (compared to 267 days in 2021), with 50% surviving one year. While clinical audit is just one part of a healthcare system working hard to achieve improvements in care, to save and improve lives, it is an essential tool in healthcare providers’ armoury. HQIP Chief Executive, Chris Gush, explains:

The NLCA is a model for how systematic audit can drive measurable, life-changing improvements. It reflects a shared commitment to ensuring that every person with lung cancer is diagnosed earlier, treated faster, and given the best possible chance of survival. Continued collaboration between clinicians, service users, data analysts, cancer charities, and policymakers will be essential to sustain this, to ensure that every patient benefits.”

Find out more

Sign up to receive HQIP’s eBulletin to receive future national audit reports, including the next NLCA Station of the Nation report due in early 2026
Article: HQIP audits pave the way to better cancer care
National Lung Cancer Audit data dashboards
Interested in improving healthcare with HQIP? Our clinical auditand quality improvement consultancy service is here to support you. Contact us on workwithus@hqip.org.uk for an initial, no-obligation conversation

Each Data Point Represents a Person and Their Family

15 Dec 2025

How lived experience is shaping HQIP’s new National Audit of Eating Disorders.

It’s estimated that at least 1.25 million people in the UK live with an eating disorder. Behind every statistic is a person whose daily life, and the lives of those who love them, is profoundly affected. The emotional and physical pain impacts patients, families, partners, and friends alike. Eating disorders can also be life-threatening: Anorexia Nervosa has the highest mortality rate of any mental health disorder, underscoring the urgent need for better care and support.

The new National Audit of Eating Disorders (NAED), commissioned by HQIP and delivered by the Royal College of Psychiatrists, aims to improve identification, management, and overall quality of care for people with eating disorders. In its first year, the audit has mapped services across England to understand the breadth and depth of current care, achieving an outstanding 97% participation rate from eligible teams and publishing a Service Mapping report that outlines what has been discovered.

Crucially, the audit has placed the voices of people with lived experience at the very centre of its work, ensuring that those who use eating disorder services, and those who care for them, directly shape how data is gathered, analysed, and shared. HQIP champions patient and public involvement in all national audits within the National Clinical Audit and Patient Outcomes Programme (NCAPOP) to ensure that improvement is not just theoretical, but grounded in the realities of those who are in need of care. Their perspectives ensure that recommendations become changes that make a difference to patients and their families, and save lives.

True co-production in action

Lived experience is never an add-on; it is a key foundation of the NAED team’s work. The principle that each data point represents a person and their family underpins the entire project.

By combining clinical expertise with lived experience insight, and supported by HQIP’s expertise in patient involvement, quality and governance, the audit aims to enhance the identification, management, and quality of care for people of all ages with eating disorders. This inclusive approach ensures that future service improvements will be guided by the realities of people’s lives, and help to translate data into meaningful, person-centred actions that can improve outcomes and save lives.

Alongside representatives from many partner organisations, two Lived Experience Advisors sit on NAED’s Implementation and Steering groups. These groups provide the project team with expertise from multiple backgrounds to plan, structure, produce, and interpret the results of the audit fully and without bias. Importantly, the Lived Experience Advisors ensure that the perspectives of people with direct experience of eating disorders are consistently heard and acted upon in every key decision.

As a Lived Experience Advisor, I have been impressed with the commitment of everyone involved in the audit. As a team we have a holistic approach, as the voices of those who use eating disorder services are combined with the voices of those who deliver them. We are working in partnership with a shared ambition of improving services and outcomes for those living with eating disorders and their families.” Rebecca Regler, Lived Experience Advisor for NAED

This commitment to patient engagement is applied to all aspects of the audit’s work. Service users who are under the age of 16 are being asked what’s important to them via a survey, and the audit also has a dedicated Service User and Carer Advisory Group (SUCAG), which brings together a diverse range of people with personal or caring experience of eating disorders. Co-facilitated with the charity Beat, the SUCAG works alongside the Steering Group, as well as clinicians, researchers, and HQIP representatives who provide oversight, guidance, and ensure that patient input is meaningfully integrated throughout the audit process. The SUCAG helps shape the direction of the audit, set its metrics and ensure that it reflects issues that matter most to patients and families.

The SUCAG’s input goes far beyond consultation too. Members reviewed the clarity and accessibility of the Service Mapping report and a forthcoming data dashboard to ensure they are inclusive and genuinely useful. Their feedback even informed how findings were presented, including designing posters for eating disorder service waiting rooms with QR codes linking directly to the national report to make the results accessible to patients and their families.

What the data reveals

Exceptional engagement, successfully mapping 297 eating disorder teams across 209 service providers in England, has resulted in the most detailed national picture of eating disorder service provision to date. Still only one year in from inception, this work lays the groundwork for future audit phases and offers new insights into both strengths and challenges, from access and staffing to treatment availability and waiting times.

The audit found high levels of multidisciplinary working and strong uptake of NICE-recommended therapies, reflecting good practice across many teams. However, it also revealed significant variation in access, service configuration, and waiting times across regions and age groups.

Waiting times ranged widely. The median wait for assessment for children and young people (CYP) is 14 days, compared to 28 days for adults. CYP typically wait 4 days for treatment, whereas for adults this median wait is 42 days – and some teams report waits of up to 700 days.
Diagnostic coverage varied. While over 90% of teams treat Anorexia Nervosa, only 60% of adult teams and 66% of CYP teams treat Binge Eating Disorder (BED), and fewer than half currently treat Avoidant/Restrictive Food Intake Disorder (ARFID) – 29% of adult and 45% of CYP teams.
Workforce pressures and variation in adult versus CYP service capacity were also highlighted, with adult teams managing 89% higher patient demand than CYP teams.

These findings offer vital insight into areas requiring targeted improvement and provide a benchmark for tracking progress in the next phase of the audit.

My son has ARFID. We were only referred because we ended up in their local hospital. Even when you get into a service there is no particular pathway. In the past five years we have been in three different teaching hospitals in London, which have all taken a very different approach.” Carer

Looking ahead

The service mapping undertaken by the NAED lays the foundation for the core audit phase beginning in 2026, which will assess services against 12 national metrics. For HQIP, as we have seen with other audits as they mature, we are confident that this will be a milestone in informing changes that will lead to improved care and patient outcomes. As such, the NAED – with its patient-focused approach – will play a key role in demonstrating the continued value of national audit in strengthening quality assurance, accountability, and patient partnership across healthcare.

National audits are strongest when patients are partners. Their experiences turn numbers into understanding, and understanding into better care. By embedding lived experience at its core right from the beginning, the NAED is creating a foundation for lasting change, ensuring that data collected truly reflects the experiences and needs of patients.” Chris Gush, HQIP CEO

Find out more

National Audit of Eating Disorders (NAED)
NAED Service Mapping Report, published December 2025
Article: The Power of Patient and Public Involvement in Healthcare Improvement
Case study: Listening to Marginalised Voices in Maternity to Help Reduce Health Inequalities
Article: How HQIP patient advocates are guiding national obesity care
How HQIP involves patients in the NCAPOP
How HQIP could support your organisation with support or training on patient engagement

Healthcare data: The key to improvement and efficiency

3 Dec 2025

HQIP’s Chair and former NHS England deputy Medical Director, Dame Celia Ingham Clark, features in BMJ Leader this month, sharing why clinical audit must play a key role in designing an NHS that is “Fit for the Future”.

“The challenges that the NHS faces are not new. With an ageing population and staff shortages, we are faced with daily news headlines about soaring costs and long waiting lists. The 10 Year Plan Fit for the Future describes the pressing need to ensure a sustainable, financially-viable future for our NHS, focusing on community care, digital technologies, and prevention. For local and national clinical leaders the real challenge comes in how to achieve this. These three ‘shifts’ need to be delivered alongside improving care quality and reducing costs. For me, the key lies in using the rich data source that is clinical audit. By measuring the quality of care, it enables us to see what is working well, and what is not, against recognised standards. It identifies where change would have the greatest impact, driving the targeted use of resources. As such, clinical audit is a critical tool in delivering efficiencies that will lead to the most important measures, improving and saving lives.

If Wes Streeting called me and asked how to drive quality improvement when designing an NHS that is “Fit for the Future”, I would say start with national clinical audits”

National clinical audit – the primary example of which is the National Clinical Audit and Patient Outcomes Programme (NCAPOP) – goes from strength to strength. Commissioned by the Healthcare Quality Improvement Partnership (HQIP), on behalf of NHS England and others, the NCAPOP comprises circa 40 audits and outcome reviews. These cover a wide range of services including cancer, mental health, and maternity care. NCAPOP has been running for decades, and measures care in line with standards set by NICE. Its programmes are trusted by clinicians and patients alike, not least because they are co-developed with both clinicians and patients. The NCAPOP has developed a robust and reliable approach to data collection, analysis and reporting, with many delivering quarterly data online updates and annual ‘State of the Nation’ reports. These reports provide readily accessible summary infographics and a focused number of recommendations for improvement that are developed with clinical, patient and commissioner input.

There are many examples of excellent audits out there; as a former colorectal surgeon I have a particular interest in the National Bowel Cancer Audit (NBOCA). Initially established by the Association of Coloproctology of Great Britain and Ireland (ACPGBI), this audit has a long-standing history of clinical engagement. It is now part of the National Cancer Audit Collaborating Centre (NATCAN) – a collaboration between the Royal College of Surgeons of England and the London School of Hygiene and Tropical Medicine – that covers ten different types of cancer, and is commissioned through the NCAPOP. The NBOCA focuses on surgical outcomes, non-surgical treatments, and new approaches to care such as genetic testing. The latter is significant as it aims to identify which patients are most likely to benefit from chemotherapy, and avoids the futile use of potentially toxic and costly treatment for patients with particular genetic profiles.

The NBOCA has reported improvements across a range of care and outcome measures over time, for example, 90-day postoperative mortality has almost halved over the past decade. There has also been a significant improvement in the two-year postoperative survival rate, resulting in approximately 1,150 additional people surviving two years after surgery¹ (2021/22 saw a 5-percentage-point increase compared with 2012/13). These statistics highlight advancements in treatment pathways and multidisciplinary patient care across the sector. They also reflect another important aspect of clinical audits. By making data publicly available, and actively working with the healthcare community to support peer review, they identify areas for improvement. Audits operate an ‘outlier process’ which identifies where indicators at a Trust level fall significantly outside the expected range². NHS England and the Care Quality Commission are notified of confirmed outliers, so that remedial actions can be taken. This is an extremely valuable process for Trusts, who often welcome the opportunity to understand where changes would have the greatest impact. One recent example is an NHS Trust that increased patient telephone follow-up on discharge to reduce unplanned emergency department attendances, following such a notification.

“Audit is not a tick-box exercise – it’s driving real improvements for patients,” Katrina Attwood, Chair of NBOCA Patient and Public Involvement Forum

Clinical audits also support initiatives to improve care pathways directly. For example, patients who have had rectal cancer surgery are recommended to have their ileostomy closed within 18 months of first surgery, and this is currently the case for only 62% of patients¹. As such, Close it Quick (a collaboration between NBOCA, the Royal College of Surgeons of England and the Association of Coloproctology) was launched to promote timely stoma closure, improve quality of life, and reduce the risk complications.

Another aspect of care where clinical audits are invaluable, is in shining a light on inequity. There are many examples where the data helps us to understand what is happening, so we have an opportunity to improve care for everyone. A highly reported example in recent years is maternity care. When looking at 2014-16 data, the MBRRACE-UK programme (part of the NCAPOP) found that women from Black ethnic backgrounds had five times the risk of maternal mortality, compared to white women. This finding emphasised the need for a continued focus on actions to address this disparity. By 2021-23, this statistic had reduced to around double. There’s still much work to be done, but, using data in this way provides clarity and shines a light on issues, leading to improvements like this.

“Clinical audit is a critical tool in delivering efficiencies that will lead to the most important measures, improving and saving lives”

So, what does all this mean for healthcare leaders, both providers and commissioners? Having been in a leadership role in the NHS for many years, I’m fully aware of the constant pressures to maintain and enhance quality of care while reducing avoidable costs. On a daily basis, you are having to ask ‘where should I allocate my resources to deliver maximum benefit to patients and the Trust?’. Clinical audits also provide assurance regarding clinical services through Quality Accounts, and in terms of performance against process and outcome metrics. Furthermore, they offer robust data that clinicians can include and reflect on in their annual appraisal.

If Wes Streeting called me tomorrow and asked my view on how to drive quality improvement when designing an NHS that is “Fit for the Future”, I would say ‘start with national clinical audits’. But, I would quickly follow that up with ‘don’t take my word for it, ask our patients’. Katrina Attwood, Chair of the NBOCA Patient and Public Involvement Forum, sums it perfectly, when she says: “I know first-hand how useful it is to have data. Audit is not a tick-box exercise – it’s driving real improvements for patients, and demystifying care, as well as shining a light on places where we need to do better.”

Notes:

1) Source: NBOCA State of the Nation report, published 9th Oct 2025

2) To 3 standard deviations

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)

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

HQIP-Commissioned Audit Sees 72.8% Increase in School Healthcare Plans for Young People with Epilepsy

17 Sep 2025

The proportion of children and young people with epilepsy who have a school Individual Healthcare Plan (IHCP) within the first year of care has jumped 72.8%, from 38.9% in the 2024 annual report to 67.2% in the latest Epilepsy12 audit 2025 report. This marked increase, after previously being broadly static for several years, highlights a major step forward in ensuring that children with epilepsy receive the support they need in school.

Epilepsy12, the national clinical audit of seizures and epilepsies in children and young people, is commissioned by HQIP as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) and has tracked paediatric epilepsy care since 2009 across England and Wales. Delivered by the Royal College of Paediatrics and Child Health (RCPCH), the audit provides essential data to benchmark services against national standards, and drive improvements and reduce variation in care.

A key factor behind the increased proportion of children and young people with IHCPs has been the direct involvement of children, young people and families themselves. The Epilepsy12 Youth Advocates group, who are epilepsy experienced or interested young people and families volunteering to improve care for patients, has been instrumental in shaping what is measured, helping to define Epilepsy 12’s key performance indicators and highlighting the issues and potential solutions.

This brings patient-led priorities to the audit, ensuring that topics such as school care plans and the mental health of children and young people with epilepsies are central, alongside more traditional healthcare metrics. This shift in focus, and the resulting improvements at scale, is a major success for the young people driving and benefitting from the improvements.

The Importance of School Healthcare Plans

IHCPs have been a key focus for the Youth Advocates (YAs) and other stakeholders over the last few years. The YAs have consistently emphasised that a good, individualised plan in school can be transformative, especially in the first year after diagnosis. Having an IHCP is key to ensuring that children and young people with epilepsy receive appropriate support, safety, and full participation in education and school life. They are vital for epilepsy, as what is right for one child can be completely different from what is right for another.

The YAs emphasised the importance of IHCPs and how they can support not only the young person, but also their family, teachers and friends to feel more confident about epilepsy. They also advocated for a comprehensive epilepsy IHCP template for schools that included crucial information, including seizure details, aspirations, and mental health, but was also easy to use. An example template was developed and is available online.

“I was diagnosed with epilepsy in 2018. My parents and I met with the School Nurse and Headmaster to create a plan. Teachers were informed and updates were made as needed. It was a learning curve for everyone. The plan allowed me to attend day trips, complete two Duke of Edinburgh’s expeditions, and go on a 7-night trip to America. Without this support, travelling would have been much more difficult.” A young person with epilepsy

Looking forward: Opportunities for further improvements

Given that having an IHCP is a statutory requirement for a young person with epilepsy, Epilepsy12 is aiming for 100% adoption and identifying easier ways to enable the sharing of key information between families, health and education. As well as continuing to build upon existing successful work to improve this KPI, encouraging further data entry and service participation will also be important. There have been significant increases in the total cohort size of health service providers submitting data to the audit and of data completeness this year, something which is extremely important when drawing conclusions from the audit data; particularly trends over time and variation between subgroups.

150 NHS Health Boards and Trusts providing paediatric epilepsy care in England and Wales were registered into the Epilepsy12 audit in 2025, via a bespoke data platform launched in December 2023. This is an increase from the 138 Health Boards and Trusts registered to the platform used previously. Of the Health Boards and Trusts registered, 80% (120/150) submitted data in this latest round of reporting (cohort 6, covering children and young people with a first paediatric assessment undertaken between 1 December 2022 and 30 November 2023).

The cohort size also increased considerably, with 3,105 young people with newly-diagnosed epilepsy included in the 2025 analysis. This compares to the previous five cohorts, which all had around 2,000 young people. Furthermore, data completeness has improved from 86% in cohort 5 (2024 report) to 98.5% in cohort 6 (2025 report).

The increased cohort size and improved data completeness may be a reflection of the streamlined data entry process on the new Epilepsy12 data platform. Find out more about this and other highlights, including epilepsy specialist nurse provision improvements, in the 2025 Epilepsy12 report.

Going forward, as well as striving to further improve data entry and service participation, the focus of the audit will continue to be reviewed. Indeed, Epilepsy12 has often seen the ambition for a particular KPI advance over time, building upon initial progress by resetting aspirations and targets. This means that the current KPI focused upon young people with epilepsy having a school care plan may well evolve – for example to having a ‘comprehensive’ IHCP and then an ‘impactful’ plan.

Epilepsy12’s latest findings underscore the importance not only of robust data, but also the power of involving children and young people in shaping the care that directly impacts their lives. By embedding patient and family at the heart of its work, it has demonstrated how genuine collaboration and co-production can deliver real-world change.

These noteworthy improvements in paediatric epilepsy care reflect not only robust national audit and patient-led advocacy, but also the ongoing commitment of key stakeholders. Initiatives such as the NHS England Epilepsy Oversight Group, including the publication of the national bundle of care for children and young people with epilepsy, and targeted programmes like the Epilepsy Quality Improvement Programme (EQIP) have driven up performance and consistency.

Furthermore, the collaborative efforts of key stakeholder groups, including Young Epilepsy, Epilepsy Action and others, ensure that the needs of children, young people, and families remain central, embedding best practice and delivering meaningful change.

Having an effective individual school healthcare plan is a vital step towards safer, equitable and empowering support for young people with an epilepsy. Seeing such a dramatic improvement in schools shows what is possible when professionals, families and young people work together at many different levels.” Dr Colin Dunkley, Clinical Lead for Epilepsy12

Further information and resources

Epilepsy12 2025 report
Interview with Epilepsy12 on what effective patient engagement means in practice
More about the Epilepsy12 audit, with previous reports
A guide to patient and public involvement in quality improvement
E-learning: Introduction to quality improvement for patients and public
Epilepsy12 Audit case study – how patients and carers influence the production of patient-focused outputs from the programme

We must build on NHS data for 10 year vision to succeed

15 Aug 2025

HQIP’s Chair and former NHS England deputy Medical Director, Dame Celia Ingham Clark features in Healthcare Leader this month, sharing why we should let data light the way in healthcare reform…

“With the release of both the 10 Year Plan and the Patient Safety Review within days of each other, I – like everyone else in healthcare – have been absorbed in understanding what they mean, for providers and patients alike. While my initial response is one of cautious optimism, my overriding thought is that we must be guided by data. Or, as NHS England Chair Dr Penny Dash, author of the Patient Safety Review, said in The Sunday Times, prior to its release ‘we collect more data on quality of care than any other country….let’s use it’.

The importance of data is stressed throughout both these documents. In fact, there are some really interesting ideas in the ‘10 Year Plan’ in particular, not least of which is a focus on evidence-based quality and prevention. A strategy that is designed to keep people healthy, and reduce the chances of them needing admission to hospital, is really important. However, we now need more detail about delivery. The Plan is a blueprint, not a roadmap. What is clear to me though, is that the data we already have must be our starting point.

I can envisage getting to a position where we have neighbourhood-level electronic health records, from which data feeds seamlessly into national clinical audits and similar programmes. It is then analysed, and interpreted with appropriate specialist input, and sent back to the neighbourhood system to inform the care delivered. Under such a system, patients will be able to see and understand – in collaboration with clinicians – what will deliver the best outcome for them.

Indeed, it’s obvious from the recent strategies that outcome measures are going to be of utmost importance going forward (not that they weren’t already, but I’m seeing a renewed focus in the 10 Year Plan). This is a key area where we need to look to what we already have. The national clinical audit programme (or NCAPOP^*) generates data spanning decades on a wide range of conditions from asthma to vascular care, supporting improved care and outcomes. One of many examples of this is the National Emergency Laparotomy Audit (NELA), whose data led to a significant reduction in mortality within a few years for patients having major abdominal surgery. Managed by HQIP on behalf of the NHS, this programme is evidence-based, clinically validated, and supports quality improvement through data-informed, actionable recommendations. Importantly, the data is also publicly available. Which brings me to two other important themes where I agree with the Plan; transparency and patient engagement.

In my eight years as a Trust CMO, I worked hard to ensure that patients were well-informed. I am a strong advocate of shared decision-making. These days, you can obtain information about some conditions, treatment options and even your clinician – but it’s not widespread. The National Joint Registry (NJR) is a great example where this data is available. We need to make it possible for patients to obtain this level of information about other specialties too – and this came across loud and clear in the 10 Year Plan. However, I would caution that we need to ensure that this data is available to everyone. The mooted neighbourhood and data systems need to pay particular attention to underserved communities, if we are to address healthcare inequities, something which is a major issue in the UK at the moment. Here again, we don’t need to start from scratch. For example, PICANet data recently showed that children from ethnic minority backgrounds and those living in areas with higher levels of poverty are more likely to die in intensive care. Audits from the national clinical audit programme have long-since shone a light on issues like this. Previously, for example, exposing the fact that black women were five times more likely to die in pregnancy or childbirth than white women (MBRRACE). This enabled care providers to focus on addressing that shocking statistic, and now we are starting to see that number reduce.

While I strongly advocate that clinicians engage with the data available to achieve change, they cannot do it alone. Policy makers need to streamline processes so that data can flow directly from the clinical record into a national system, whereby it can be analysed and produce results that are of value at both local and national levels. The “revamped, revitalised and reinforced” National Quality Board (NQB) has an opportunity to do just this. Its mooted leads, Professor Sir Mike Richards and Dr Penny Dash, are both experts in recognising the importance of data to drive quality improvement, but their challenge will be to work with organisations like HQIP to focus on the measures that will make a difference to patient outcomes. That means more real-time reporting, which we saw being accelerated during the COVID-19 pandemic (for example, with the National Child Mortality Database (NCMD), shared real-time data to inform paediatric care at that time). There are many other national audits that now follow this example, such as the National Cancer Audit Collaborating Centre (NATCAN), which shares quarterly data via an online dashboard.

Looking forward, this vision of a data-informed healthcare system should be supported by technologies such as AI. It could, for example, play an increasing role in data analysis which would, in turn, speed up sharing findings and recommendations. This is echoed in the 10 Year Plan. And, no less than the ‘Godfather of AI’, Geoffrey Hinton, agrees. At a public lecture at the University of Bristol on 2 June 2025, he was asked where he thought AI would deliver the greatest benefit. Without hesitation, he answered ‘healthcare’.”

*The National Clinical Audit and Patient Outcomes Programme (NCAPOP) is the largest programme of its kind in the UK; it is commissioned by HQIP on behalf of NHS England. It includes 44 national clinical audits and outcome review programmes, including the National Emergency Laparotomy Audit (NELA), PICANet, MBRRACE, the National Child Mortality Database (NCMD), and the National Cancer Audit Collaborating Centre (NATCAN)

Patient voice in clinical audit: A powerful partnership improving asthma and COPD care

18 Jul 2025

With the NHS 10 Year Plan promising to “put power back in the hands of people and professionals to make the best choices about their own lives, treatment and care”, and highlighting the crucial role that clinical audit will play, the HQIP-commissioned National Respiratory Audit Programme (NRAP) is just one example of how clinical audit already involves patients meaningfully to improve care and outcomes.

Patient-engaged clinical audit to improve discharge outcomes

Having a little time at discharge to make sure everything you’re expecting has happened – and you’ve planned for anything you maybe aren’t expecting – can make the process of going home feel less daunting and can break the cycle of breathing problems before they get worse again.” Heather, patient

NRAP, delivered by the Royal College of Physicians (RCP), recently released Catching Our Breath, a report offering important insights into the current state of respiratory care across England and Wales – including highlighting a need for improved discharge planning.

Effective discharge planning is key to ensuring better health outcomes for patients with asthma and COPD. In 2023–24, only 47%* of people with asthma received all required asthma discharge bundle elements, while only 28%* of people with COPD received all elements of their discharge bundle. For children and young people (CYP), only 25%* with asthma received all three elements required for best practice CYP asthma discharge planning.

Patient panels, alongside Asthma and Lung UK and clinicians, considered how best to share and promote the report’s key messages to patients and the public, seeking to empower people to understand the healthcare that they should be receiving during treatment and, in particular, at discharge.

It’s vital to include the voice of people with lived experience throughout the production of resources from clinical audits. Everything we do as an audit is to improve patient care and outcomes, so we should always produce resources in collaboration with the people that they are intended for.” Ellie Rochell, NRAP Project Manager

One approach didn’t fit all

Co-designing resources with adults: Initial discovery sessions with both the adult and CYP groups gave participants the opportunity to consider how they would like to share the audit outputs with patients and the public – and highlighted that the groups had different concerns, priorities and requirements.

The adult panel really valued being able to see the data and understand what it meant in terms of their healthcare. Ensuring that the data was accessible to patients and the public was a priority for them. This meant much thought was given to the presentation of data, such as including infographics and fully explaining what each graph or figure showed.

They decided that a patient and public version of the original report, using less technical jargon and explaining the ‘why’ behind the recommendations, would be beneficial, and proposed the inclusion of a glossary to explain terminology and acronyms.

A first draft of this patient and public report was shared with the panel in an insight gathering session, as well as further rounds of feedback via email. The group had final sign off on the report, ensuring their changes and requirements had been addressed. This report is available and is now being used to support adults with asthma and COPD.

Co-designing resources with children and young people (CYP): In comparison, many in the CYP group found the data and figures quite daunting. Instead of sharing these figures with other children and young people, the group wanted to create a resource to empower people to understand what they should receive from hospital when being discharged after an asthma attack.

The CYP joined a design day which included the attendance of a graphic illustrator, funded by RCPCH, to capture their ideas as they were generated. This led to the creation of two resources:

For CYP and their families/caregivers: What should you expect to receive when you’re discharged from hospital after an asthma attack? This explains why these aspects of care are important, and includes prompt questions they may want to ask healthcare professionals.
For CYP hospital teams: Checklist for discharge from hospital after an asthma attack. A simple document for healthcare workers to complete with CYP and their families when being discharged.

I really appreciate how lung patients are now given the chance to share experiences. Years ago, this was not possible. The people living with these conditions are as much of an expert as the medical professionals.” Sue, patient

Clinical audit’s critical role in the 10 Year Plan

Our recent news article highlights how the new NHS 10 Year Plan acknowledges the important role that national clinical audit will play in its delivery. In challenging and rapidly changing times, involving patients from the very beginning of commissioning audits ultimately enables better quality services that are more responsive to the needs of patients, focusing on the areas that truly matter to them, their families and carers.

NRAP demonstrates how thoughtful, patient-informed clinical audit engages patients and leads to improved care outcomes – because only they truly know the impact that their illness has on them. For an audit to be its most effective, patient involvement in the dissemination of findings, and the development of resources, is crucial. This ensures that information is accessible, relevant and, above all, useful in delivering care.

Heather, a respiratory patient, sums things up perfectly by reminding us: “It’s understandable that inputting data will be pushed down the priority list when you are constantly stretched for time. But, as patients, we rely on this audit process to help make sure our conditions are managed consistently.”

More on patient engagement in clinical audit

Discover more about how HQIP supports organisations to use clinical audit to drive improvement and undertake meaningful patient engagement
Join our Service User Network (SUN)

*Refers to the percentage of people recorded as being in receipt of a discharge bundle. Additionally, in England there is best practice tariffs available for COPD and adult asthma discharge bundle completion.

The importance of data in the ‘Patient Safety Review’

9 Jul 2025

HQIP’s Chair and former NHS deputy Medical Director, Dame Celia Ingham Clark, agrees with NHS England’s Chair, Dr Penny Dash, when she says “we collect more data on quality of care than any other country…let’s use it, let’s get it out there”. Here Celia outlines why data – and clinical audit and outcomes data – will be crucial to the success of the ‘Review of patient safety across the health and care landscape’, published this week.

“Before seeing the ‘Patient Safety Review’, I read an article in The Sunday Times with Penny Dash where she explained more about its remit, setting the tone for its release a few days later. What immediately jumped out at me was her strong focus on the key role that data would play in her vision for improved patient safety.

This was evident when I saw the published version of the Review, which states: “The NHS is one of the most data-rich healthcare systems in the world and has historically been at the forefront of collecting and reviewing data for clinical audit purposes. There is considerable opportunity to build on this with more data sharing across organisations…enabling [them] to identify and focus on the most significant issues and challenges to improve care”. At HQIP, where we run the largest national clinical audit and outcomes review programme in the UK (NCAPOP) on behalf of the NHS, we have long-since advocated this sentiment.

We collect more data on quality of care than any other country. Let’s use it, let’s get it out there,” Dr Penny Dash, then NHS England Chair

The Review was by the commissioned by the Secretary of State for Health and Social Care, Wes Streeting, to examine the patient safety landscape and make recommendations to support improved quality of care. It is littered throughout with references to the value of data, and clinical audits (including those delivered by HQIP*), in achieving this; and rightly so.

The role of national clinical audit

National clinical audits provide independent, transparent evidence for improvements that will have maximum impact on patient care, including keeping them safe. They are trusted by healthcare providers and patients alike. The 44 audits and programmes in HQIP’s NCAPOP, identify where current practices are falling short, highlight what ‘good’ looks like, and make the case for changes that will improve and save patients’ lives. They often demonstrate that survival rates improve when certain interventions need to be delivered earlier in the care pathway.

Data and analytics should be playing a far more significant role in supporting the quality of health and social care,” Patient Safety Review, July 2025

However, data alone is not enough; it’s the interpretation of that data that matters. Or, as the Review puts it: “insufficient use is made of the NHS’s data resources to generate insights and support improvement”. At HQIP, we understand the need to translate data into quality services. We do not simply publish data; we help healthcare providers and leaders to understand what to do with it. It’s critical that we all work together to turn insights into meaningful action.

Putting patients at the centre of patient safety

What do we mean by ‘meaningful’ (forgive the duplication here, but it’s that important)? It’s a phrase that’s often bandied about, but it is critical in relation to patient care. To me, it means delivering safe care that meets the needs of patients. Nothing more, nothing less. If it isn’t what patients want and need, then it isn’t valuable. This, too, is reflected in the Review and indeed the ‘NHS 10 Year Health Plan for England’ published days before. When care falls short, patients deserve answers and action. Importantly, HQIP works with patients to co-design its audit programmes, and ensure that recommendations for change are clear, fair and focused on outcomes. So, I was pleased to read the Review’s emphasis on working with patients to improve safety, concluding with a call to “capture and learn from user or patient experience” and involve the “voice of the user”.

Transparency, transparency, transparency

Another theme that comes across loud and clear from the Review, and other recent announcements from the DHSC, is the need for transparency. Without it, we cannot build trust. It makes perfect sense. The more that we can all see what is happening, the more we can all work together to improve. Again, HQIP’s clinical audit programme is uniquely positioned to support transparency. Through the NCAPOP, clinical data is brought into the open. Every report, finding and recommendation is publicly available for all to see and use – from clinicians and healthcare leaders through to patients and their representative groups, everyone can access the programme’s data.

I will conclude by turning my attention to the Review’s recommendations for the “revamped, revitalised and reinforced” National Quality Board (NQB) which, it states, “should be responsible for developing a comprehensive strategy to improve quality of care”. It’s telling that the very first item in the first of these recommendations is a need to build on data and analysis that supports current quality of care. It states that the NQB should “make more effective use of existing NHS data resources (including large-scale audits or registries and routine data)”. The Review goes on to say that “data and analytics should be playing a far more significant role in supporting the quality of health and social care”. This goes without saying. However, I will say it nonetheless – I couldn’t agree more.

^*Review of patient safety across the health and care landscape, July 2025: “Data on the quality of care is collected through a range of mechanisms, including national clinical audits commissioned by the Healthcare Quality Improvement Partnership (HQIP) and other registries and audits (such as those run by colleges, NHS England and others).”

Clinical audit is critical for NHS 10 Year Plan

4 Jul 2025

The NHS 10 Year Health Plan for England was published this week, promising extensive reform and focusing on three ‘shifts’: prevention, community care, and technology. It is an ambitious strategy that asks a great deal of the health service, and crucially it acknowledges the important role that national clinical audit will play in its delivery. The Plan makes a strong case for a renewed focus on outcome measures and quality improvement, recognising that the NHS must make full use of the clinical audit and registry programmes already in place.

There is a moral obligation to use the data that is already available, for the benefit of patients” Phil, NHS patient

As noted in the Plan, HQIP’s National Clinical Audit and Patient Outcomes Programme (NCAPOP)* will play a key role in ensuring that reform is grounded in evidence. The largest programme of its kind in the UK, it includes 44 national clinical audits and clinical outcome review programmes, covering a wide spectrum of conditions and services across the NHS. Managed independently, and trusted by patients and clinicians alike, these audits measure quality of care, providing a clear view of what is working well and where improvement is needed most. Data from this programme has been collected, analysed and published for decades, and supports clinical effectiveness, patient safety, equity in access, and outcomes for patients. Its impact is well evidenced, for example improving survival, identifying variation, supporting better use of NHS resources and informing clinical guidance (eg Epilepsy12 contributed to NICE guidance on the importance of timely specialist input for children with suspected epilepsy).

This NHS Plan emphasises transparency and accountability, including commitments to publish provider-level quality data, and expand the use of digital tools such as the NHS App. It outlines plans to enable patients to search for healthcare providers based on clinical outcomes, patient feedback and waiting times (pages 13-14). This is precisely the kind of data that HQIP already commissions. Our audits are structured, trusted, publicly available and co-designed with patients. Used by clinicians, regulators, commissioners and patient groups, they provide a robust foundation for the Plan’s ambitions. Their inclusion in this document reinforces this credibility, and underscores their value to the NHS in the future: “There are multiple audits and reviews of quality of care routinely carried out within the NHS in England…for example, 30 audits as part of the national clinical audit programme [and] 5 clinical outcome review programmes” (page 87).

As healthcare becomes more data-driven, the NHS has a huge advantage” 10 Year Health Plan

Chris Gush, HQIP’s CEO, explains: “Audit data is one of the few constants across the system, cutting across organisational boundaries and clinical disciplines to track the impact of reforms.” In other words, clinical audit is uniquely placed to support improvements that will deliver maximum impact, and hold a mirror up to the system as it changes.

How will HQIP clinical audits support the 10 Year Plan?

By supporting “an NHS that is fit to face the future” (Prime Minister, Kier Starmer, 3^rd July 2025) through the three ‘shifts’ set out in the Plan:

From sickness to prevention

Audits can identify where avoidable harm occurs and where earlier intervention can reduce the need for crisis care. CVDPrevent, which focuses on the prevention of cardiovascular disease, has seen increases in interventions to reduce the risk of CVD eg 85% of people with, and 62% of high-risk patients without pre-existing, CVD are now prescribed lipid-lowering therapy. By highlighting both successes and areas needing improvement, it provides GPs, neighbourhood teams and commissioners with the information they need to act earlier, direct investment more intelligently, and design services around keeping people well. Equally important is the role that audits play in tackling health inequalities. Whether through neonatal mortality data revealing stark ethnic disparities, or stroke audits showing variation in access to post-acute rehabilitation, audit data makes inequality visible, measurable and actionable.

From hospital to community

Audits follow the patient, not the building. By tracking care across the pathway, they generate evidence on where services could – and should – be delivered closer to home. For example, the National Respiratory Audit Programme (NRAP) has recently published a review of asthma and COPD care across both hospitals and the community recommending that patients should be offered alternatives to centre-based care where appropriate. These insights help local systems redesign care around the person, not the institution. Furthermore, patient voice is embedded in HQIP’s audit system, supporting the move towards personalised, community-based services that respond to what matters most to the individual.

From analogue to digital

Audit data is already structured, standardised and linkable across settings. It works on the principle of ‘collect once, use multiple times’, and is well-placed to feed into the development of single patient records and real-time dashboards. HQIP’s audit data are already publicly available and they are linked to primary and secondary care data, hospital episodes, mortality statistics and disease-specific registries. This creates a unified view of care quality over time, which can be easily fed into platforms such as the NHS App and the broader ‘digital ecosystem’ that the Plan seeks to make more available to both patients and healthcare providers. For example, HQIP already publishes comparative provider-level outcomes for stroke, cancer, orthopaedics (we host the National Joint Registry) and many other specialties. These are exactly the kinds of metrics that will prove pivotal when delivering informed patient choice, to improve standards across the system.

So, it’s clear that the 10 Year Plan recognises the critical value of data in delivering reform, stating that ‘as healthcare becomes more data-driven, the NHS has a huge advantage’. Professor Danny Keenan, HQIP’s Medical Director and Associate Medical Director at Manchester University NHS Foundation Trust, agrees, providing a clinician’s point of view: “If we are to reduce variation, improve outcomes, and drive smarter investment in services, then the system needs high quality, trusted data.”

Given that the aim of the Plan is to “bring the state – and the people it serves – into a partnership” (Kier Starmer, 3^rd July 2025), that partnership must be based on patient feedback. As such, the final word should go to an NHS patient, Phil, who volunteers with HQIP: “There is a moral obligation to use the data that is already available, for the benefit of patients”. We are heartened to know that the NHS is in agreement.

*Page 87 of the NHS 10 Year Plan: “There are multiple audits and reviews of quality of care routinely carried out within the NHS in England. These include, for example, 30 audits as part of the national clinical audit programme, 5 clinical outcome review programmes and the Getting it Right First Time programme.” Note that the National Clinical Audit and Patient Outcomes Programme (NCAPOP) includes ten audits that fall under one ‘umbrella’ cancer audit

Further information

The NHS 10 Year Plan
National Clinical Audit and Patient Outcomes Programme (NCAPOP)
National Clinical Audits and Outcome Review Programmes in the NCAPOP
Reports and infographics commissioned by HQIP
The National Joint Registry

Audit drives improvements in neonatal care

2 Jul 2025

Data from the National Neonatal Audit Programme (NNAP), commissioned by the Healthcare Quality Improvement Partnership (HQIP), shows a significant improvement in the adoption of a life-saving intervention for preterm babies. The audit has played a vital role in identifying neonatal care providers with lower-than-national-average rates of Deferred Cord Clamping (DCC), a practice which is known to reduce mortality.

In 2023, 68.3% of babies born at less than 34 weeks’ gestation in England, Wales, Scotland and the Isle of Man received DCC. In 2022, the proportion was 60.4%, indicating a striking 7.9% improvement in one year. This demonstrates the vital role that clinical audit plays in saving lives, given that evidence shows that DCC may reduce the chance of mortality by around 32%*.

Clinical Lead for the NNAP, Dr Sam Oddie explains: “Deferring cord clamping in preterm babies, as opposed to clamping the umbilical cord immediately after birth is highly recommended, because it has been shown to reduce mortality by approximately a third.”

The world stopped and nothing else mattered,” Nick and Gemma, parents of baby Allegra

Data from the NNAP shows that adoption of DCC in the UK has previously been very low, at less than 29% as recent as 2020. However, there has been a steady increase since, with the rate expected to be over 70% in 2024 (publication date October 2025). By identifying neonatal networks and units with lower than national average rates, the NNAP has played an important part in supporting this major change in clinical practice, assisting partner agencies and programmes to increase adoption of DCC. Importantly, it can also lead to even further improvements. Dr Oddie shares how: “While UK neonatal clinicians can – rightly – be proud of their evidence-informed change in practice, they should now reflect on occasions when DCC doesn’t seem appropriate. This will support the next stages in researching how it should be delivered, and help to achieve even better outcomes.”

Delivered by the Royal College of Paediatrics and Child Health (RCPCH), the NNAP assesses whether babies admitted to neonatal units receive consistent high-quality care, identifying variation and supporting improvement through evidence-informed change. In addition to neonatal care, the audit also reports on perinatal care, maternal breastmilk feeding, parental partnership, neonatal nurse staffing levels, and other important care processes. The NNAP’s data dashboard is a frequently updated resource for those involved in neonatal and perinatal care (details at the bottom of this article). It provides care providers with monthly-updated results, as well as benchmarking and data cleaning tools. As such, it gives an accurate and up-to-date picture of their performance, enabling early intervention where improvement initiatives are needed.

Evidence shows that DCC may reduce the chance of mortality by around 32%

The NNAP is one of more than 40 national clinical audits and programmes commissioned by the Healthcare Quality Improvement Partnership (HQIP) on behalf of the NHS and other bodies, as part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP). This unique programme – the largest of its kind in the UK – measures and reports on a variety of clinical disciplines, from asthma to vascular care, and helps to drive local, regional and national improvements in healthcare.

Chris Gush, HQIP’s CEO, commented: “As demonstrated by the NNAP, audit data highlights the changes that will have the greatest impact on patient outcomes. It is critical in ‘lighting the way’ for system leaders and clinicians alike, to understand where to target resources, particularly in these changing times when pressures have never been greater.”

The NNAP’s impact does not stop at improving the adoption rates of DCC. Other reported improvements include a 9.4% increase (between 2022 and 2023) in the national adherence to screening for retinopathy of prematurity (ROP), with 78.4% of eligible babies being screened according to the guideline. There was also 4.1% increase over that same time period of babies born at less than 34 weeks being admitted with a temperature within the recommended range. In addition, their work also focuses on parent partnership in care – reporting that breastmilk feeding at two days of life increased to 62% in 2023, an increase of 13% from 2022.

The importance of these improvements cannot be underestimated. Driven by national clinical audit, they represent not just newborn babies – whose lives have been saved and improved as a result – but also their loved ones. As such, the final word must go to one such family. Nick and Gemma, the parents of baby Allegra, who further underline the importance of improved neonatal care, when they describe the “feeling of how the world stopped and nothing else mattered” when their daughter was born at 31 weeks’ gestation.

* Fogarty, M. et al. Delayed vs early umbilical cord clamping for preterm infants: a systematic review and meta-analysis. Am J Obstet Gynecol. 2018 Jan;218(1):1-18. doi: 10.1016/j.ajog.2017.10.231. Available at: https://pubmed.ncbi.nlm.nih.gov/29097178/

Links to further information on this article

NNAP Summary report on 2023 data
Further information on DCC on page 73 of the extended analysis report, and the ‘key finding’ for DCC in the summary report is on page 7
This webinar, held in October 2024, reviewed the Key Findings and Recommendations from the NNAP State of the Nation report on 2023 data.

Case studies on DCC

Improving Rates of Optimal Cord Management in Preterm Infants Including Delivery of PEEP During Transition with an Intact Cord – QI Central
Optimal Cord Management in preterm infants – a Quality Improvement project – QI Central
Deferred Cord Clamping in Preterm Infants – QI Central

Further information on HQIP

Healthcare Quality Improvement Partnership (HQIP)

Every patient deserves safe, high quality care, and national clinical audits and similar programmes (such as the NCAPOP and the National Joint Registry, both run by HQIP) help to make that happen, by measuring the quality of care across hospitals and services. These programmes collect and analyse data to show what is working well in healthcare, and where improvements are needed. HQIP is an independent, not-for-profit long-term partner of the NHS that is led by the Academy of Medical Royal Colleges and the Royal College of Nursing. More data and quality improvement resources from HQIP.

Further information on NNAP

National Neonatal Audit Programme (NNAP)

The NNAP supports professionals, families and commissioners to improve care provided by neonatal services who look after babies born too early, with a low birth weight or who have a medical condition requiring specialist treatment. For more information on the impact of the NNAP for 2024.

Reports: The NNAP publishes an annual summary, and extended analysis, reports on the previous year’s data. The summary report summarises key messages and national recommendations, based on NNAP data relating to babies discharged from neonatal care in England, Wales, Scotland and Isle of Man for that year. The extended analysis report provides in-depth results and a summary of findings by audit measure, along with next steps and resources. You can find these reports here.

Dashboard: NNAP has two publicly available dashboards:

1) NNAP Online: Report Data, which can be used to:

view an overall annual summary report for a chosen neonatal unit or network
view and compare the results for specific NNAP audit measures for different units, unit designations or networks
view, via the outlier analysis section, whether a result for a unit or network is outside the expected range.

2) Public Access Dashboard, which provides results for each of the 10 NNAP performance metrics as annual rolling averages. Results can be displayed for neonatal units, Integrated Care Systems and Health Boards (Wales and Scotland), and by neonatal network. These results are updated monthly. There is also a Restricted Access Dashboard, for unit and network users to view their NNAP data (access to this resource is limited to participating neonatal units and networks).

Resources for parents & carers: The NNAP also publishes a parent and carer guide to the audit, Your baby’s care. The guide covers the NNAP measures most relevant to parents and carers, as chosen by parents and carers of preterm babies, supported by neonatologists. It includes images and quotes from parents and carers of preterm babies who received neonatal care. We encourage neonatologists and paediatricians to share it with parents. You can find this report here.

Blog: HQIP’s role in delivering NHS priorities

2 Jul 2025

From Data to Action

How HQIP, Clinical Audits, and Registries Can Support National NHS Priorities for 2025/26

As the NHS shares its operational planning guidance for 2025/26 this week, it’s vital to understand the role that clinical audits and registries can play in supporting the delivery of the priorities it outlines. By providing high-quality data, they are an essential tool for improving patient care, reducing inequalities, and enhancing productivity. HQIP’s CEO, Chris Gush, explains how the national programmes commissioned by HQIP, on behalf of the NHS, are critical to delivering NHS 2025/26 priorities. HQIP manages several national clinical audits (NCAs), clinical outcome review programmes (CORPs), and hosts the National Joint Registry (NJR). These initiatives, delivered by our partner organisations, generate essential data covering a spectrum of clinical disciplines ranging from asthma to vascular care. With key insights and clear recommendations for improvement, they enable healthcare providers to evaluate care quality, support continuous improvement, and inform strategies to achieve national NHS objectives. Importantly, they have the potential to save and improve lives, at the same time as reducing the burden on resources. Find below just some examples of the many ways these programmes contribute to the NHS’s 2025/26 priorities and operational planning guidance, illustrating their vast potential to support improvement in healthcare.

Reducing Time for Elective Care and Cancer Treatment Standards

National Priority:

65% of patients to receive elective treatment within 18 weeks by March 2026.
Improve cancer waiting time standards: 75% compliance with the 62-day target and 80% with the 28-day Faster Diagnosis Standard (FDS).

HQIP’s Role in Priority Delivery:

National Joint Registry (NJR): Tracks outcomes of hip, knee, shoulder, elbow, and ankle joint replacements, providing data on implant longevity, surgical performance, and patient outcomes. Insights can help reduce elective care delays by improving surgical pathway efficiency and resource allocation.
National Cancer Audit Collaborating Centre (NATCAN): This ground-breaking centre, the first of its kind, consolidates ten cancer audits including breast, ovarian, pancreatic, non-Hodgkin lymphoma, prostate, oesophago-gastric, bowel, lung, and kidney cancer. These audits provide up-to-date essential data on diagnosis, treatment pathways, and outcomes, enabling faster and more effective care delivery.

These programmes guide local and national strategies to optimise referral management, streamline diagnostics, and improve patient choice within elective and cancer care pathways.

Improving A&E and Ambulance Response Times

National Priority:

Improve A&E waiting times (78% of patients admitted, discharged, or transferred within 4 hours).
Reduce Category 2 ambulance response times to 30 minutes on average.

HQIP’s Role in Priority Delivery:

National Respiratory Audit Programme (NRAP): Provides key data on the management of acute exacerbations of asthma and COPD in emergency settings. This audit supports improvements in A&E care for respiratory patients by identifying gaps in treatment protocols and patient flow management.
Sentinel Stroke National Audit Programme (SSNAP): Examines the quality of care delivered to stroke patients in the crucial hours following stroke onset and monitors long-term management and rehabilitation. It provides ambulance trusts with intelligence on response and conveyance times for stroke patients. The audit also supports quality improvement activities, helping patients to recover faster and with better results.

By identifying current best practice and areas for improvement in urgent and emergency care, these audits contribute to reducing handover delays, enhancing same-day emergency care, and improving operational efficiency.

Enhancing Access to General Practice and Dental Care

National Priority:

Increase the number of urgent dental appointments and improve general practice access and patient experience.

HQIP’s Role in Priority Delivery:

National Diabetes Audit (NDA): Tracks the management of diabetes across primary and secondary care, identifying gaps in care and opportunities for better integration between general practice and specialist services.

National Audit of Cardiovascular Disease Prevention in Primary Care (CVDPrevent): Supports improvements in the prevention and management of cardiovascular disease (CVD) by providing data on care delivery in primary care settings. This audit highlights opportunities for better integration of preventive measures, particularly for at-risk populations, to reduce long-term complications and hospital admissions.

These audits enable Integrated Care Boards (ICBs) to develop targeted action plans to address variations in care delivery and access, ultimately improving patient outcomes and experience.

Improving Mental Health and Learning Disability Care

National Priority:

Reduce average length of stay for adult acute mental health inpatients and expand access to CYP mental health services.

HQIP’s Role in Priority Delivery:

National Clinical Audit of Psychosis (NCAP): Focuses on measuring the quality of care provided by Early Intervention in Psychosis (EIP) teams, ensuring prompt, evidence-based assessment and treatment for first-episode psychosis. The audit aims to improve service access, optimise care pathways, and reduce inpatient stays.
National Audit of Eating Disorders (NAED): Focuses on improving the quality of care for patients with eating disorders, particularly children and young people (CYP). This audit examines early intervention strategies, care pathways, and treatment outcomes, supporting better access to timely, evidence-based mental health services.
Mental Health Clinical Outcome Review Programme (NCISH): Examines incidents of suicide among mental health service users. By identifying risk factors and systemic issues, this programme helps improve patient safety, ensuring patients receive timely, high-quality interventions and support.
National Child Mortality Database (NCMD) – Suicide in Children and Young People: This report investigates the factors and characteristics associated with child and adolescent suicides. It provides critical recommendations for improving mental health support services, early intervention, and prevention strategies for vulnerable young individuals. The findings guide service providers and policymakers in reducing risks and enhancing support systems for children and young people.

These projects help identify systemic barriers to timely mental health care, supporting reforms to reduce unnecessary inpatient stays and improve service access for children and young people.

Addressing Inequalities and Shifting Towards Prevention

National Priority:

Reduce health inequalities through the Core20PLUS5 approach and enhance prevention strategies for conditions such as cardiovascular disease and diabetes.

HQIP’s Role in Priority Delivery:

National Vascular Registry (NVR): Evaluates the care and outcomes for patients undergoing major vascular procedures such as aneurysm repair and lower limb revascularisation. The NVR identifies variations in access and outcomes, supporting improvements in preventive care and reducing inequalities in vascular health.
National Paediatric Diabetes Audit (NPDA): Maintains a focus on identifying and addressing variations in paediatric diabetes care processes, treatment, and outcomes by socio-demographic groups. The audit highlights health inequalities through detailed reporting, breaking down outcomes by ethnic category and deprivation quintile. This work is part of the NPDA’s 2022-2027 Quality Improvement Strategy, which earned the Health Inequalities Hero Award in recognition of its efforts to reduce disparities in diabetes care.
Maternal, Newborn and Infant Clinical Outcome Review Programme (MBRRACE-UK): Identifies factors contributing to maternal and infant mortality, providing targeted recommendations to reduce inequalities in perinatal and maternal outcomes.
National Audit of Cardiovascular Disease Prevention in Primary Care (CVDPrevent): A national primary care audit that extracts routinely held GP data to support primary care in understanding how many people with cardiovascular disease (CVD), or conditions that lead to a higher risk of developing CVD, are potentially undiagnosed, undertreated, or overtreated. The audit prioritises working with system partners to drive CVD quality improvement at individual GP, Primary Care Network (PCN), and Integrated Care System (ICS) levels.

These projects support ICBs and providers in developing strategies to improve early intervention, disease management, and access to care in underserved communities. Blog – Yes we can: The importance of national clinical audit in addressing health inequalities. In this article, Professor Danny Keenan, Medical Director at HQIP, explains how clinical audits can support a better understanding of, and help to address, healthcare inequalities.

Driving Digital Transformation

National Priority:

Shift from analogue to digital systems, with increased use of digital communications, electronic patient records (EPR), and integrated data platforms.

HQIP’s Role in Priority Delivery:

HQIP is actively collaborating with EPR providers, trust-based Business Intelligence Units (BIUs), and the clinical audit community to drive digital transformation. This involves integrating clinical audits and outcome review data into digital platforms to facilitate real-time access for clinicians and system leaders, enhancing data-driven decision-making and care improvement efforts.
National Joint Registry (NJR): Integrates with digital systems to provide up-to-date data on surgical outcomes, enhancing decision-making for elective care and resource planning.

These efforts support the adoption of digital tools that improve patient outcomes and operational efficiency, reducing administrative burden and enabling data-driven care.

Reducing Costs, Improving Productivity, and Living Within Budget

National Priority:

Achieve a 1% reduction in the cost base and a 4% improvement in productivity, including a 30% reduction in agency expenditure.

HQIP’s Role in Priority Delivery:

Clinical audits help identify inefficiencies and areas for cost-saving, such as reducing unwarranted variation in clinical practice and optimising procurement processes.
The Falls and Fragility Fracture Audit Programme (FFFAP): Highlights preventive measures, such as improved fracture care and falls prevention strategies, which can reduce hospital admissions and associated costs.

By providing evidence on productivity and efficiency improvements, HQIP supports the NHS’s goal to live within budget while maintaining high-quality care.

Ensuring Quality and Safety

National Priority:

Deliver key actions of the maternity and neonatal ‘Three Year Delivery Plan’ and maintain a strong focus on service quality and safety.

HQIP’s Role in Priority Delivery:

Maternal, Newborn and Infant Clinical Outcome Review Programme (MBRRACE-UK): Provides crucial insights into the safety of maternity and neonatal services, supporting improvements in care for mothers and infants.
National Maternity and Perinatal Audit (NMPA): Evaluates the quality of care provided to women and their babies during pregnancy and childbirth. It identifies variations in care, highlights current evidence and best practice, and supports improvements in safety and outcomes across maternity services.

These projects provide essential data to improve patient safety, reduce clinical risks, and ensure compliance with national standards for maternity and neonatal care. HQIP recognises that the path to reform, as outlined in the 2024 ‘Darzi Report,’ presents significant challenges. Achieving the NHS’s current priorities requires sustained effort and collaboration across the health and care system. However, by working together – using robust evidence to drive targeted improvements where they will have the greatest impact – we can share this responsibility and achieve meaningful progress. As demonstrated above, HQIP’s national clinical audits and outcome review programmes are instrumental to the delivery of the NHS’s 2025/26 priorities. By providing timely, comprehensive, and high-quality data on a national scale, these initiatives support Integrated Care Boards (ICBs), trusts, and providers in addressing key objectives. This includes improving patient care, reducing health inequalities, and driving efficiency and productivity. With a shared commitment to data-driven reform and continuous quality improvement, we can collectively deliver sustainable, high-quality healthcare that meets the evolving needs of patients and healthcare professionals alike.

Further information

Data, infographics and other outputs from HQIP-commissioned programmes: www.hqip.org.uk/resources/?fwp_resource_type=reports

The Big ‘C’ – Collaboration

3 Jun 2025

The power of an evidence-based, knowledge-sharing approach to cancer care – and how we can learn from this across healthcare

With more than 1,000 new cancer diagnoses, and almost half that number dying, every day in the UK¹, the stakes have never been higher for those engaged in cancer care. But they are not alone. They have data. More importantly, they are supported by dedicated professionals across the healthcare system, all committed to harnessing that data to enhance care and, ultimately, improve outcomes. Professor Danny Keenan, Medical Director at the Healthcare Quality Improvement Partnership (HQIP), shares his experience of being a part of that system, sharing knowledge and working collaboratively to target resources, and save and improve lives. The National Cancer Audit Collaborating Centre (NATCAN) is a unique centre of excellence, commissioned by HQIP on behalf of NHS England and the Welsh government; the first of its kind in the UK. Delivered by the Clinical Effectiveness Unit (CEU) at the Royal College of Surgeons of England (RCSEng), it encompasses ten cancer audits including prostate, kidney and colon². While a recent BBC article highlighted variations in care identified by NATCAN’s data for these cancers in particular, it is this level of detailed understanding that will be key to improving patient outcomes. These audits provide up-to-date essential data on diagnosis, treatment pathways, and outcomes, and, as such, have the potential to support more effective care delivery. Or, to quote Professor Ajay Aggarwal, Clinical Director at NATCAN: “We often hear people talking about what the next breakthrough is but, the fact remains, using what we have better could make a huge difference.” While it’s important to share issues such as variations in care, we need to acknowledge the unbelievable work and dedication that goes into collecting and analysing the data to produce these insights, as they point the way to improvement. But data alone cannot bring about meaningful change. For that, you need the combined efforts of multidisciplinary professionals, to scrutinise the data, and its resultant recommendations, from a myriad of perspectives.

“We often hear people talking about what the next breakthrough is but, the fact remains, using what we have better could make a huge difference,” Professor Ajay Aggarwal, Clinical Director at NATCAN

The Executive Quality Group National Clinical Audit (EQG-NCA) is one such team (one of many, of course, dedicated to translating data into actionable improvement across healthcare). Reporting to the NHS England National Quality Board and the Welsh Government, this group exists to condense the national recommendations from the National Clinical Audit and Patient Outcomes Programme (NCAPOP), managed by HQIP, into clear actions improvement within the NHS. At a recent cancer-focused EQG-NCA meeting (involving HQIP, NATCAN, NHS England and others³), we discussed the first major output from the Centre, reviewing the full breadth of outcomes from all ten NATCAN audits. Chaired by the National Lead for Secondary Care, Stella Vig, I was struck by how vibrant it was. With such an important issue to address, it was intense, as you can imagine – but this was fuelled only by a shared determination to understand what is working well and what is not, in order to deliver maximum benefit for patients.

“We’re in the middle of a real data revolution in the health service,” Professor Peter Johnson, National Clinical Director for Cancer at NHS England (2023)

The meeting began with presentations from HQIP, NATCAN and NHS England; the content of which immediately brought home to me the advantage of gathering such a diverse set of colleagues together. These presentations covered the first reports from the six newer NATCAN audits as well as annual reports from the remainder² (see Resources – HQIP for these, and other, reports commissioned by HQIP). It was also a chance to share more about the benefits and logistics of having a single collaborative ‘umbrella’ centre to ‘house’ all the major cancer audits, as well as underline HQIP’s change in emphasis to fewer metrics and more focused recommendations. More specifically, we heard that the ten audits had reduced the total number of recommendations to just 48 – with Care Pathway and Treatment each accounting for 20%, and Staffing and Training representing 14%. This approach supports the translation of data into action. The complexity of NATCAN’s work is exemplified by the fact that they collate data from a wide range of sources including the National Cancer Registration and Analysis Service (NCRAS), the Cancer Outcomes and Service Dataset (COSD), Hospital Episode Statistics (HES), and the Office for National Statistics (ONS) as well as seven other national datasets. This alone demonstrated to me the expertise needed to create their outputs. Speaking for NATCAN, Professor Aggarwal, highlighted some key points:

For some cancers, such as ovarian and pancreatic, outcomes remain poor with much variation nationally
Variation in the management of older cancer patients in particular is a key theme across the audits.

We also heard concerns about getting robust data back to units in a timely manner. There was discussion around the delays in receiving some sources of non-NATCAN data. The NHS England Treatment Variation team gave an update on the role of the Cancer Networks in addressing this issue. These are an invaluable resource in managing this and many other aspects of cancer care. They also emphasised the need to work closely together, as epitomised by NATCAN.

“There is an extraordinary richness of NHS datasets [that] is largely untapped…in clinical care,” Lord Darzi, NHS England 2024 review

There were many positive messages coming out of the data too. We heard about a great example of a positive outlier, and discussed how to share the learning from that unit. Professor Aggarwal concluded by stressing that clinical communities, professional bodies and others from across cancer care now need to use NATCAN’s data to define a new ‘standard of care’ for some measures.

Recent reports from NATCAN

Details of outcomes from England and Wales from the National Cancer Audit Collaborating Centre (NATCAN) published in January 2025 include:

National Oesophago-Gastric Cancer Audit (NOGCA) report(care received between 1 Apr 2021 and 31 Mar 2023).
National Prostate Cancer Audit (NPCA) report (care received from 1 Jan 2019 to 31 Dec 2023)
National Bowel Cancer Audit (NBOCA) report (care received between 1 April 2022 and 31 March 2023).

More data: All cancer, and other, clinical audit and outcome review reports commissioned by HQIP can be found here.

Following on from the presentations, there was an incredibly stimulating discussion led by the Chair, Stella Vig, and the National Clinical Director for Cancer, Peter Johnson (NHS England), together with Ajay Aggarwal. This covered multiple themes including integrating recommendations for GIRFT and registries. Other topics covered were: the need to highlight the influence of factors such as age, frailty and ethnicity; the use of Artificial Intelligence (AI); updating datasets; and the role of consultant job planning in supporting audits. In summary, it was extremely inspiring to meet with a group of people with such diverse expertise, all of whom have the same aim: better outcomes for patients. For me, what was unique was the interplay and knowledge-sharing between clinicians, data analysts and healthcare civil servants and managers, all working together to better understand the data and recommendations, and identify actionable improvements. By virtue of the nature of the EQG-NCA, patients were not present, but they were very much front and centre of everyone’s minds throughout. Indeed, we concluded with a session concerning patient reported outcomes and experience, and how to better include these when setting up audits.

HQIP may be an obvious vehicle for a series of audit reviews, supporting an evidence-based, multi-disciplinary understanding of care

The aim of this article is to provide insight into what happens at a strategic level with the data that is produced from audits, with cancer care as an example. It is important to share that the evidence and outputs from national clinical audits, outcome reviews and registries play a critical role in understanding the changes needed to improve patient experience and outcomes. Through activities like the EQG-NCA meetings, you can see that this evidence also directly informs the actions needed to achieve that improvement. In other words, to quote Lord Darzi in his NHS England 2024 review, there is an “extraordinary richness of NHS datasets [that] is largely untapped…in clinical care” and, as such, the clinical audit community plays an important role in the NHS’s “roadmap to reform”. The EQG-NCA has already held similar meetings concerning maternity and neonatal care. However, there are many other areas that could benefit from such reviews and, in fact, this does not have to be achieved through the EQG-NCA. Indeed, if we all work together outside of – but complementing the work of – this group, we could include service users and a more diverse group of healthcare professionals. On further reflection, given the success of this cancer themed meeting, HQIP may be an obvious vehicle for a series of such audit reviews, supporting an evidence-based, multi-disciplinary understanding of care related to a range of areas. These could include clinical disciplines, ranging from COPD to diabetes, as well as hospital-specific themes such as intensive care and paediatrics. Perhaps the way forward is to gather together an association of the willing, but possibly not so easily heard, to involve a wider, more diverse group of colleagues who, I am sure, have great ideas but need a forum for their release? I hope you agree that building on the success of meetings such as this cancer review would be a very worthwhile and productive venture. I, for one, would embrace a platform where colleagues from across the healthcare system can work together to pool their collective knowledge – supported by clinical audit outputs – to contribute to a national approach to improved health outcomes for everyone through evidence-informed, patient-centred quality improvement (which just happens to be HQIP’s vision!). Watch this space…

Notes

1) Source: Cancer Research UK (2017-2019) – www.cancerresearchuk.org/health-professional/cancer-statistics-for-the-uk. 2) Audits included in the National Cancer Audit Collaborating Centre (NATCAN): Added in 2023

Pre-2023

3) Organisations represented at the February 2025 meeting of the Executive Quality Group National Clinical Audit (EQG-NCA):

Healthcare Quality Improvement Partnership (HQIP)
NHS England represented by the Medical Directorate, Cancer Services, Quality Strategy and Clinical Programmes, Treatment Variation, National Disease Registration Service and more
National Cancer Audit Collaborating Centre (NATCAN)
Welsh Government
National Disease Registration Service (NDRS).

The untapped potential in NHS EPRs got me thinking about the time we cut preventable VTE by 48%

13 May 2025

Turning clinical audit into action

By Clare Fountain

The Health Foundation recently released a timely piece on electronic patient records (EPRs) and NHS strategy. It makes a strong case for the potential of EPRs to deliver safer, more efficient care – if we can get the design, integration, and usage right. Yet as the report makes clear, potential doesn’t equal impact. We still face major gaps in how data is shared and used at the front line. Data needs to flow to those who need it, in real time, to support better decision making. This got me reflecting on a project I led over a decade ago, during a sabbatical from the NHS at Baylor Health System in Texas (now Baylor Scott & White) in 2009-11. It was a different context, but the principles – especially around standardisation, reliability, and frontline usability – feel more relevant than ever.

Real-time guidance, not retrospective learning

At Baylor, we set out to tackle the preventable harm caused by hospital-acquired venous thromboembolism (VTE). A familiar NHS initiative. Instead of relying on static protocols or disconnected audits, we embedded a standardised, evidence-based VTE order set directly into the EPR – as a decision support tool. I worked with clinicians to turn US VTE guidelines into an algorithm, coded into the EPR. It was tailored in real time to each patient, triggered by their risk factors at admission. The headlines:

The process was clinically-led, mandated by all 13 hospital Clinical Directors, and focused on process reliability, not just education.
We didn’t ask clinicians to remember the guidelines, we built them into the workflow – and so made it easier to do the right thing than not.
At the same time as standardising the default, clinicians could use their clinical experience to deviate, and document why.

The result? A 48% drop in hospital-acquired VTE

The impact of the initiative, documented in my MSc dissertation, was clear:

VTE prophylaxis prescribing became more consistent and appropriate (often chemical and physical prophylaxis combined)
Real-time data improved adherence and feedback loops
Hospital-acquired VTE fell by 48% in just six months

These results weren’t achieved through heroic effort or top-down compliance. They came from:

Standardising what we knew worked
Making it visible and useable at the point of care
Focusing on system reliability, not individual blame

It aligned well with improvement theories I’d studied, including Juran and Deming’s concepts of ‘designing in quality’ – standardise until you need to customise – and Nolan’s framework of reliability in healthcare systems. When we moved beyond hoping clinicians would remember the latest, changing guidance and started designing for consistent performance, things changed.

The opportunity for the NHS

We’re seeing promising signs of clinical decision support in UK EPR systems – particularly in primary care, where tools like EMIS and SystmOne routinely include alerts, risk scores, and prescribing prompts. But secondary care adoption is more uneven. While some trusts using systems like Cerner or EPIC are embedding real-time decision support, others are still grappling with fragmented workflows and inconsistent functionality. That’s a major opportunity: to standardise not just data collection, but decision support – and to design it into clinician workflows, just as we did at Baylor. To make real-time decision support work reliably at scale, we need agreed definitions of what ‘good care’ looks like in each clinical scenario. Ideally these should be evidence-based, with clinician and patient input, regularly updated, and already widely recognised. That’s where existing work done in support of national clinical audits could fit in. The NCAPOP programme, commissioned by HQIP, already provides a rich set of measures grounded in clinical and patient consensus, often aligned with NICE guidelines. These aren’t just useful for retrospective performance reports – they could also be used to power real-time prompts and care pathways within EPRs. Given that we already have these measures across a huge number of specialties, are we maximising their benefit? Could we move from collecting data retrospectively to using these same measures to support care as it happens? Decision support tools may improve consistency and outcome of direct care, as my project showed. And the digital data they generate in doing so is then ripe for secondary use, such as comparative national clinical audit, and also for real time outcomes monitoring. I’ve seen what’s possible when evidence is built into systems, not just policies. When standardisation reduces variation where we don’t need it, we free up doctors’ cognitive load to focus on clinical judgement for the complex and nuanced decisions where it matters most. In the NHS today, we are reaching 100% EHR coverage. But reading the Health Foundation report made me wonder:

How do we enable this kind of intelligent, real-time support at scale across a health system with multiple EPR providers, local variations, and varied digital maturity?
Does AI bring new opportunity for real-time clinical decision support using national clinical audit measures?

I hope before too many more years pass that we will see for every national clinical audit:

Data captured once, in real time at the point of care
Data collated nationally, for benchmarking and equity analysis
Data interrogated locally, for variation and improvement
Measures used to support evidence-based care now, with real-time decision support

This isn’t about replacing audit. It’s about realising the full value of the work already being done – turning measures into daily decision support, in addition to retrospective systemic learning.

A role for HQIP and our partners

HQIP has been at the forefront of clinical audit for over 15 years. From the outset, we have championed the use of digital, point-of-care data as the gold standard for audit. But we now need to go further. We are proactively engaging with EPR vendors to explore how audit measures could be integrated into their platforms. We want to work with clinical leaders, digital teams, and patient representatives to co-design decision support tools rooted in the very measures that national audits already use. If we succeed, we can reduce unwarranted variation, drive up the quality of care, and generate real-time data that serves both direct care and systemic learning. The Health Foundation’s call to action is clear. Real-time data is only valuable if it informs real-time decisions. We already have the measures. We are rapidly acquiring the infrastructure. The missing link is intelligent design and shared commitment. I have seen what is possible when evidence is embedded into systems, not policies. When we stop hoping clinicians will remember the latest guidance and start building reliability into the workflow, the results speak for themselves. The question is no longer whether we can do this. It is whether we are willing to.

More information

Discover more about how HQIP supports organisations use clinical audit to drive improvement
Contact us on workwithus@hqip.org.uk for an initial conversation

Background: Clinical Audit and Quality Management

Clinical Audit and Quality Planning: Identifying opportunities for improvement

Clinical Audit and Quality Improvement: Improving patient care and outcomes

Clinical Audit and Quality Control: Ongoing measurement of quality

Clinical Audit and Quality Assurance: Evidence based compliance with standards

Further resources from HQIP

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Recent reports from NATCAN

Notes

Other news

Turning clinical audit into action

By Clare Fountain

Real-time guidance, not retrospective learning

The result? A 48% drop in hospital-acquired VTE

The opportunity for the NHS

A role for HQIP and our partners