NHS boards failing to engage on clinical quality audits

The Healthcare Quality Improvement Partnership surveyed 110 clinical audit managers and 62 per cent said the quality of board level interaction with audit was either poor or needed improvement.

They show we have improved awareness of audit, but what is missing is boards recognising they can do something with it

Only 45 per cent said the amount of board level engagement had increased in the past year. Clinical audit was neglected as a method of quality improvement and governance until 2008, when the Department of Health set up the partnership to increase their profile and manage national audits.

From June all provider trusts will have to declare the number of national audits they have taken part in, and account for how they are governing and improving care in their quality accounts.

HQIP chief executive Robin Burgess said: “The results are telling us boards know there are audits going on - which they have to for the purposes of regulation and monitoring - but they don’t use it in a way they could to drive quality improvement.

“Audit is supported by the Department of Health and is a proxy for the quality of a trust’s clinical governance,” he said.

The survey results, shared with HSJ, showed 60 per cent had seen an increase in clinical audit in the past year, and 67 per cent said implementation of the audits had improved. They cover acute, mental health and primary care trusts.

Mr Burgess said: “They show we have improved awareness of audit, but what is missing is boards recognising they can do something with it - that is what we are now concentrating on.”

He said engaging with audit was important to improving quality of services and assuring there were no major clinical problems like those identified at Mid Staffordshire Foundation Trust and Basildon and Thurrock University Hospitals Foundation Trust.

He said: “Boards can’t afford to let it slip. If they get it wrong they could end up in the position of Mid Staffs or Basildon.”

Commenting on the findings, associate medical director at Northampton General Hospital Trust Natasha Robinson, who is in charge of clinical audit there, said: “Our trust has participated in almost all of the national audits and confidential enquiries, but the board needs to know this is happening, and to understand what this means for the organisation and how we are using it to improve care and raise standards.”