National and Local Clinical Audit 30/04/2015 Kate Godfrey Director of Operations QI and Development

Who are HQIP?

Our work National Clinical Audit and Patient Outcome Programme 30+ national audits covering: Acute Cancer Children and Women's Health Heart Long-term Conditions Mental Health Older People Clinical Outcome Review Programmes 4 ongoing national programmes: Maternal, Newborn and Infant Medical & Surgical Mental Health Child Health Programme National Joint Registry Collects joint replacement information, monitoring implant, hospital and surgeon performance: Holds 1.75m+ records Includes hips, knees, ankles, elbows and shoulders Covers England, Wales and Northern Ireland Mandatory for NHS since 2011 Quality Improvement and Development Supports QI at local level nationally and internationally via: Evidence based guidance Practical tools and case studies Patient and public involvement Regional training events eLearning and webinars Network Support

Clinical audit and the quality of services ‘The quality of care varies. It varies between hospitals and between other care organisations. It varies within those organisations, between services, between wards, between shifts and between individual practitioners.’ Hard Truths: the journey to putting patients first. The government’s further response to Robert Francis QC’s report on the Mid Staffordshire NHS Foundation Trust public inquiry. response?dm_i=1V12,201LU,BL6PA6,7792D,1 response?dm_i=1V12,201LU,BL6PA6,7792D,1

What is clinical audit? Clinical audit is about checking that patients are treated correctly and receive the best care. It looks at the care given and compares it to standards of best practice. The priorities for national audits are set centrally by NHS England with advice from the National Advisory Group for Clinical Audit and Enquiries (NAGCAE) All NHS trusts are expected to participate in NCAPOP.

What is clinical audit? Most clinical audit activity in NHS trusts involves clinical teams evaluating aspects of care that they see as important and need improving. This is local clinical audit. National clinical audit is designed to improve patient outcomes across the country in a wide range of medical, surgical and mental health conditions. Clinical audit is only one of many quality improvement methods

Clinical audit

Example of National Stroke Audit Results

Complete Audit

Clinical Outcome Reviews Programme Tracheostomy Care: On the Right Trach? Lower Limb Amputation: Working Together Why Asthma Still Kills NCISH Annual Report (2014) Child Health Maternal, new born and infant mortality

NCAPOP Audits Lung Cancer Head and Neck Cancer Bowel Cancer Oesophageal-gastric cancer Prostate Cancer Sentinel Stroke National Audit Programme (SSNAP) COPD FFFAP (Falls, Fragility and Fractures Audit Programme) UK Inflammatory Bowel Disease Rheumatoid Arthritis Chronic Kidney Disease National Diabetes – Adult National Diabetes – Paediatric National Vascular Registry Neonatal (NNAP) Epilepsy 12 Paediatric Intensive Care (PICANEt)

NCAPOP audits Adult Cardiac Surgery Heart Failure MINAP Angioplasty Audit Heart Rhythm Management Congenital Heart Disease/Paediatric Surgery National Emergency Laparotomy Audit In development Alcoholic Liver Disease HIV/STI Breast Cancer Maternity Dementia Ophthalmology

Local Audit Clinical Effectiveness Patient Safety – risks, complaints…. Local / Regional Importance Patient Experience Cross trust – non specialty specific areas Patient pathway within and between organisations

Key Messages A clinical audit is not complete until the quality of services has improved. A clinical audit programme must be focussed on clinical priorities and risks to patient safety A clinical audit which does not result in improved services and increased patient safety is a waste of resources.

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