- Local audit network criticises increasing burden of national audit programme
- The annual survey of audits finds negative perception outweighs positive for the first time
- Concerns include lack of timely data reporting, poor methodology and incompatible IT infrastructure
The national audit programme is a “drain” on hospital trusts’ resources when projects are “poorly designed or insufficiently robust”, a regional audit network has warned.
The Yorkshire effectiveness and audit regional network has submitted a paper to the Healthcare Quality Improvement Partnership, which said the taxpayer could save “considerable sums of money” if a minimum audit criteria was followed.
YEARN intends to share its recommendations to “national bodies” responsible for commissioning and providing audits and has already escalated its concerns to the National Quality Improvement and Clinical Audit Network, the independent body representing networks such as YEARN. The paper said it recommends that any audit not meeting its criteria “should not form part of the national programme”.
The paper comes at the same time as an annual survey of clinical auditors found that negative perceptions of audits outweighed positive for the first time since the survey launched in 2010. In 2015-16 the differential between whether auditors felt more or less positive about clinical audits fell to -4.2, compared to 10 in 2015 and 47.4 in 2010.
Of the 218 responses to the survey carried out by the Clinical Audit Support Centre, 77 per cent of acute trust respondents wanted less auditing, while 63 per cent of community and mental trust respondents wanted more.
CASC director Stephen Ashmore said: “We have met many trust auditors and clinicians that have told us that there are simply too many national audits. We are told trusts are stretched with no more capacity in the system and yet still have to spend a lot of time generating data that is often slow to be benchmarked and reported back.”
The qualitative responses to the survey included anonymous comments that “[audits] are seen as too much work for too little return”; “they do not influence change on a scale that justifies the resource”; and “national audits are driving out local projects which typically lead to the biggest improvements in patient care”.
Mr Ashmore also said there are few national audits for community, mental health, primary and social care, which is unbalanced and “does not mirror how healthcare is delivered in 2017”.
The findings are in line with the concerns raised by YEARN.
Sandra Halstead, clinical audit manager at Mid Yorkshire Hospitals Trust, said: “We are not criticising having national audits we are absolutely signed up to providing them. It is about the quality of those audits and the impact on trusts. It needs to be managed effectively to be reasonable. When I produce our internal programme I have to resource it and see how it will work – that should happen nationally.”
The YEARN paper made several recommendations including outlining explicit standards and criteria that the audit should address; a timely reporting of data back to the trust; IT systems that are compatible with trusts’ infrastructure; and a robust methodology
A HQIP spokesman said: “The National Clinical Audit and Patient Outcomes Programme is an evolving programme of work, with our projects being at different stages of maturity. All have ambitious aims to improve the information and reporting that they provide. HQIP has agreed with YEARN to formally respond to its paper in early February and is currently completing that response.”