Clinical audit

What is clinical audit?

Clinical audit is a way to find out if healthcare is being provided in line with standards and lets care providers and patients know where their service is doing well, and where there could be improvements. The aim is to allow quality improvement to take place where it will be most helpful and will improve outcomes for patients. Clinical audits can look at care nationwide (national clinical audits) and local clinical audits can also be performed locally in trusts, hospitals or GP practices anywhere healthcare is provided.

The National Clinical Audit and Patient Outcomes Programme (NCAPOP)

NCAPOP audits are commissioned and managed on behalf of NHS England by the Healthcare Quality Improvement Partnership (HQIP). The programme comprises more than 30 national audits related to some of the most commonly-occurring conditions. These collect and analyse data supplied by local clinicians to provide a national picture of care standards for that specific condition. On a local level, NCAPOP audits provide local trusts with individual benchmarked reports on their compliance and performance, feeding back comparative findings to help participants identify necessary improvements for patients. Most of these projects involve services in England and Wales; some also include services from Scotland and Northern Ireland.

As well as the 30-plus national clinical audits, NCAPOP also encompasses the four Clinical Outcome Review Programmes (CORP). These help assess the quality of healthcare and stimulate improvement by enabling clinicians, managers and policy makers to learn from adverse events and other relevant data.

National Quality Improvement & Clinical Audit Network (N-QI-CAN)

The National Quality Improvement & Clinical Audit Network, N-QI-CAN, is the ‘network of networks’ and has representation from all regional networks, some national/specialist networks and national groups such as royal colleges and HQIP.

National Advisory Group on Clinical Audit and Enquiries (NAGCAE)

NAGCAE provides policy and strategic advice to NHS England on clinical audit and enquiries.  It was established to drive the reinvigoration of the national clinical audit programme and provide a national focus for discussion and advice on matters relating to clinical audit and enquiries.

The National Advisory Group for Clinical Audit & Enquiries (NAGCAE) was established in April 2008 (as the National Clinical Audit Advisory Group). It provides a voice for clinical audit in NHS England. Unlike the two other core professional activities aiming to enhance health and social care quality, namely education and research, clinical audit had previously lacked a national strategy and a coherent programme of activities.

NAGCAE endeavours to meet its challenges by enhancing the existing programme of national clinical audits and enquiries, and seeking to support the many NHS staff involved in local audits and enquiries in their own Trusts. It also seeks to improve connections – between the centre and the periphery; between national clinical audits, regardless of their source of funding; between clinical enquiries into adverse outcomes; between quality assessment and quality improvement interventions such as revalidation, regulation and commissioning; and between clinical audit and other routine data collection in the NHS.

To achieve these goals, the members of NAGCAE reflect the diverse range of backgrounds, skills and interests that are needed to understand the challenges and devise appropriate policies:

  • Professor Nick Black (Chair): Professor of Health Services Research, London School of Hygiene & Tropical Medicine
  • Dr Mick Peake: Consultant in Respiratory Medicine, University Hospitals of Leicester NHS Trust
  • Professor Pauline Ong: Professor of Health Services Research, Keele University
  • Andrew Middleton: Lay Member; Non-Executive Member, South Lincolnshire CCG
  • Dr Geraldine Walters: Director of Clinical Nursing, King’s College Hospital NHS FT
  • Mark Gritten: Ex-CEO NHS acute Trusts
  • Professor Jan van der Meulen: Professor of Clinical Epidemiology, London School of Hygiene & Tropical Medicine
  • Amanda Edwards: Deputy Chief Executive, Social Care Institute for Excellence
  • Dr Steven Berg: General Medical Practitioner, Bexley
  • Jane Rippon: Company Director, Quality & Governance Solutions Ltd
  • Katharine Young: Senior Quality Improvement Lead, Royal Berkshire NHSFT
  • Dr Nick Bishop: National Professional Advisor, CQC

Terms of Reference. NAGCAE’s responsibilities are:

  • to provide policy and strategic advice to NHS England on clinical audit, national confidential enquiries and other issues as requested;
  • to support the reinvigoration of clinical audit, both nationally and locally, so as to stimulate improvements in clinical practice and service delivery;
  • to provide advice and guidance to NHS England on the National Clinical Audit and Patient Outcomes Programme (NCAPOP) including advising on topics for new national clinical audits, on topics to be discontinued and on the selection of tenders for supplying national clinical audits; and
  • to provide advice and guidance to NHS England on the Clinical Outcome Review Programme (CORP) including advising on clinical areas for national enquiries, on areas to be discontinued and on the selection of tenders for supplying national clinical enquiries. (Note: this does not include responsibility for advising on specific topics within a clinical area).