Clinical Audit – A simple guide for NHS boards and partners

The Healthcare Quality Improvement Partnership (HQIP) has published a free guide for NHS boards and partner organisations on clinical audit.

HQIP commissioned the Good Governance Institute to write the guidance, the content of which includes the following:

– Purpose and benefits of clinical audit
– 10 simple rules and key questions for boards
– Statutory requirements and responsibilities of organisations
– How the Board, its members and committees can gain assurance around clinical audit programmes
– A matrix to assess the maturity of an organisation’s approach to clinical audit

Parkhill, a leading assurance provider hosted by Imperial College Healthcare NHS Trust, has been looking at the new guidance for Healthcare Governance Review.

Parkhill’s Director of Audit Helen England says “This is a well structured and accessible document obviously aimed at getting board members to think about and evaluate their role in respect of clinical audit.”

A highly regarded associate of Parkhill’s who specialises in clinical governance, Owen Lloyd, says “First impressions are that this is a comprehensive document, well referenced and structured, using clear and simple language that a board would understand. It will be very good for autonomous provider organisations as they emerge from within PCT governance. It’s also helpful to have references to the role of commissioning-only PCTs, but perhaps it could have gone even further. Any approach to clinical audit needs to link clearly to world class commissioning (WCC) and the duties/priorities it imposes on PCTs. The main features of WCC are light on clinical governance, let alone clinical audit, so it’s become harder to make the connections and develop an approach to implementing/establishing clinical audit strategically in PCTs.”

Parkhill’s Lead Consultant on Governance, Assurance and Risk Management, Paul Johnston, particularly welcomes the timely appearance of this document, coming as it does within 12 months of the Audit Commission’s extensive and very well received Taking It on Trust – A review of how boards of NHS trusts and foundation trusts get their assurance (April 2009).

The Audit Commission document took an in-depth look at most board’s failure to use clinical audit as a source of organisational assurance at board level. “Both the Audit Commission and HQIP documents,” says Paul Johnston, “set out the difference between internal and clinical audit and also how Internal Audit should assure the board of progress being made in turning clinical audit into the invaluable source of assurance on clinical performance that it could and should be, and which most boards desperately need.”

Download a copy of the guidance Clinical Audit: A Simple Guide for NHS Boards & Partners here.

3 Responses to Clinical Audit – A simple guide for NHS boards and partners

  1. Paul Johnson says:

    At a recent Board seminar I facilitated looking at “Taking It On Trust”, (in fact the morning after the Francis Inquiry report came out,) there was a lot of interest in clinical audit and how underwhelmed the Board was with its non-contribution to assurance on clinical care and standards. This is beginning to look like a big issue for 2010/11. I think Katherine Birch’s team in Mersey IAA are going to be very busy..

  2. HQIP’s publication is indeed welcome and timely, and I share much of what others have said above. I would add that there needs to be a strong focus on clinical audit at Board level but within a wider culture of quality improvement, and that whilst clinical audit is a powerful assurance mechanism, this can only be achieved if the clinical audit system brings about strong engagement from clinical staff across the organisation. Audits need to be owned and improvements led by those responsible for the audit itself, which can be an issue when many audits are undertaken by junior doctors on rotation. There therefore needs to be: consistency in how audits are undertaken; rigour in the process; and confidence in the robustness of the methods employed. I would suggest that all Board members need to consider: how information pertaining to their clinical audit framework/plan is presented/received at Board level; how actual improvements (the raison d’etre for clinical audit.) are evidenced; and the skills and resources required within the clinical audit function and across the Trust to achieve the desired outcomes.”

  3. NB: Dr Katherine Birch is Programme Lead, Healthcare Quality Team, MIAA

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