Complete guide to NHS clinical audit in the UK — HQIP national clinical audits, local audit processes, quality improvement methodology, audit cycle, NICE compliance, and audit software.
NHS trusts must participate in 50+ national clinical audits commissioned by HQIP. Clinical audit is a CQC inspection domain and essential for quality improvement. This guide covers the complete audit process.
Clinical Audit Cycle
- Identify topic: Choose audit topic based on risk, volume, or national priority
- Set standards: Define evidence-based standards (NICE, Royal College guidelines)
- Design audit: Define sample, data collection method, and timeline
- Collect data: Collect data on current practice against standards
- Compare: Compare actual practice against agreed standards
- Analyse: Identify gaps between practice and standards
- Implement change: Implement improvements to close gaps
- Re-audit: Re-audit after changes to confirm improvement
Key National Clinical Audits
| Audit | Topic | Frequency |
|---|---|---|
| SSNAP | Stroke care | Continuous |
| NHFD | Hip fracture | Continuous |
| NDA | Diabetes (adults) | Annual |
| NAD | Dementia care | Annual |
| NLCA | Lung cancer | Annual |
| NABCOP | Breast cancer (older) | Annual |
| NMPA | Maternity and perinatal | Annual |
| NACR | Cardiac rehabilitation | Annual |
| ICNARC | Critical care (CMP) | Continuous |
| TARN | Trauma | Continuous |
Quality Improvement Methods
- PDSA cycles: Plan-Do-Study-Act — small-scale iterative improvement
- Lean: Eliminate waste, streamline processes, value stream mapping
- Six Sigma: Reduce variation using statistical methods
- Root cause analysis (RCA): Investigate incidents and identify causes
- Significant event analysis (SEA): Learn from significant events
- Quality improvement collaboratives: Trusts working together on shared problems
Frequently Asked Questions
- What is a clinical audit in the NHS?
- A clinical audit is a quality improvement process that compares actual clinical practice against agreed standards to identify areas for improvement. It follows the audit cycle: set standard → measure practice → compare → implement change → re-audit. All NHS trusts must participate in national clinical audits and conduct local audits.
- What is HQIP?
- HQIP (Healthcare Quality Improvement Partnership) is funded by NHS England and the Welsh Government to commission national clinical audits and patient outcome programmes. HQIP manages 50+ national clinical audits covering major conditions and procedures. Trust participation in HQIP audits is mandatory.
- What are the key national clinical audits?
- Key national audits: National Audit of Dementia, National Hip Fracture Database, Sentinel Stroke National Audit Programme (SSNAP), National Diabetes Audit, National Audit of Breast Cancer, National Lung Cancer Audit, National Maternity and Perinatal Audit, and National Audit of Cardiac Rehabilitation.