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clinical auditS U P P O R T C E N T R E

The state of clinical audit -Results of the online survey (December 2010)

Developed and produced by

Clinical Audit Support CentreRaising standards in clinical audit

The online survey was devised by Clinical Audit Support Centre (CASC) and

supported by SNAP surveys. CASC sent an e-postcard on 15th December 2010

to a random selection of 700 individuals with an interest in clinical audit inviting

them to participate. The survey remained open for 10 days and closed at

midnight on Christmas Eve.

The survey incorporated a total of 13 main questions relating to a range of

current issues relevant to the clinical audit community.

Over the course of 10 days a total of 182 returns were received. Given that

individuals may have forwarded the initial e-postcard to take part in the survey

to other colleagues it is impossible to determine the exact response rate.

However, it is possible to determine with certainty that the response rate was

not greater than 182/700 (26%). Although this represents a modest response

rate, we would like to thank all those who gave up their time and submitted

responses.

Although our preference would have been for a response rate inexcess of 50%

we are confident that the results of this survey are reflective of the views of the

wider clinical audit community. We would also point out that the response rate

compares favourably to the Healthcare Quality Improvement Partnership’s 2010

stakeholder survey (16% return rate).

It should be noted that it is CASC policy to conduct all healthcare surveys in a

confidential manner and we did not ask respondents to provide any personally

identifiable data.

It should also be noted that comments received via the survey are included in

the appendicies. All comments made by respondents have been left as they

were submitted. We have not made any alterations to these. Where the exact

comment has been received we have grouped these together. All unique

comments are displayed individually.

As stated above, minimal ‘personal’ data was collected as part of the survey.

Respondents were asked a number of ‘demographic’ questions.

These included:

1) How would you classify yourself? (possible answers were ‘clinical audit

professional’, ‘clinical governance professional with responsibility for clinical

audit’, ‘clinician with interest/responsibility for audit, or ‘other’).

Clinical Audit Survey 20102

Background

The respondents

Response rate

2) How long have you worked in clinical audit? (free text response)

3) What sector do you work in? (possible answers were ‘Acute Care’, ‘Primary

Care’, ‘Mental Health’, ‘Ambulance Trust’ or ‘other’). Those who replied ‘other’

could then clarify further via free text.

Of the 182 respondents, the vast majority (67.0%) classified themselves as

‘clinical audit professionals’. Collectively the 182 respondents had amassed

1501 years worth of clinical audit experience. All sectors of healthcare were

represented in the survey with 42.3% of respondents from the acute sector,

21.4% from primary care and 16.5% from mental health. Given that the survey

was carried out online and took approximately ten minutes to complete, the

quality of responses was high – with few missed answers reported.

Clinical audit professional (122) 67.0%

Clinical governance professional with responsibility for audit (46) 25.3%

Clinician with interest/responsibility for audit (9) 4.9%

Other (5) 2.7%

Answers ranged from 1 year (8 responses) to 31 years (1 response). 6

respondents did not reply to this question. Further analysis showed two mode

results 3 and 10 years (both with 19 respondents).

1-5 years (65) 36.9%

6-10 years (56) 31.8%

11-15 years (28) 15.9%

16 years or more (27) 15.3%

The average time worked in clinical audit from the 176 respondents = (1501

years/176 respondents) = 8.53 years.

Acute Care (77) 42.3%

Ambulance Trust (8) 4.4%

Mental Health (30) 16.5%

Primary Care (39) 21.4%

Other (28) 15.4%

See Appendix 1 for further information in terms of how those that replied ‘other’

defined their sector of work.

3Clinical Audit Survey 2010

Q1. How would you classify yourself? (n=182)

Q2. How long have you worked in clinical audit?

Results by age banding were as follows (n=176):

Q3. What sector do you work in? (n=182)

The initial set of results relates to all 182 respondents.

*A total of 30 respondents (16.5%) did not reply as they noted that ‘I did not

work in clinical audit in 2006’. Of the remaining 152:

More positive (90) 59.2%

More negative (18) 11.8%

Neither positive/negative (44) 28.9%

*1 person did not reply. Of the remaining 181:

Yes (136) 75.1%

No (45) 24.9%

*24 (13.2%) respondents stated ‘I have not taken part in National Clinical

Audits’. Of the remaining 158:

Excellent (10) 6.3%

Good (56) 35.4%

Average (74) 46.9%

Poor (17) 10.8%

Very poor (1) 0.6%

A total of 109 (59.9%) qualitative responses were received. Of these, 16 did not

focus on a specific national audit project. For example, comments included:

‘don’t know’, ‘I have not been involved’, ‘I don’t deal with national audits’, ‘any

NBS audit’, etc.

93 responses named a single national audit or a group of national audits, e.g.

‘IBD or care of the dying’. In the small number of instances where multiple

replies were given by one respondent, each named audit has been allocated a

single vote.


Results

Q4. In 2006, the Chief Medical Officer stated a need to ‘reinvigorate clinical audit’.With this in mind, do you now feel more positive or negative about audit than in2006?

Q5. Do you still intend to work in clinical audit/or have responsibilities for clinicalaudit in five years’ time?

Q6. Overall, how would you rate the quality of National Clinical Audit projects thatyou have taken part in?

Q7a. What do you consider to be the most effective national audit?

The following NCA’s gained at least 3 votes:

National Sentinel Stroke Audit 27

Acute Myocardial Infarction (MINAP) 14

National Falls and Bone Health Audit 12

Prescribing in Mental Health Services (POHM) 5

National Audit of Violence 3

National Hip Fracture Database 3

National Continence Care Audit 3

National IBD Audit 3

Diabetes Audit 3*

*In the case of the Diabetes Audit – respondents did not specify if their answer

related to the National Paediatric Diabetes Audit or the National Adult Diabetes

Audit.

Please note, the full list of responses for question 7a can be found in appendix

2.

A total of 107 (58.8%) qualitative responses were received. Of these, 23 did not

focus on a specific national audit project. For example, comments included: ‘all

those that are data counting exercises’, ‘I am not sure’, etc.

84 responses named a single national audit or a group of national audits, e.g.

‘Falls/Continence’. In the small number of instances where multiple replies were

given, each named audit has been allocated a single vote.

The following NCA’s gained at least 3 votes:



Diabetes Audit 5*



National Audit of Schizophrenia 3

Head and Neck Cancer (DANHO) 3

*see comment above in 7a for clarification.

Please note, the full list of responses for question 7b can be found in appendix

3.


Q7b. What do you consider to be the least effective national audit?

*15 (8.2%) of those surveyed did not reply. Of the remaining 167:

Local audits (131) 78.4%

National audits (36) 21.6%

For question 9, those who completed the survey were asked to ‘tick all

responses that apply’.

Excel (172) 94.5%

Access (92) 50.5%

Snap (40) 22.0%

Formic (34) 18.7%

SPSS (31) 17.0%

Survey Monkey (29) 15.9%

Teleform (12) 6.6%

Keypoint (7) 3.8%

CRT Viewpoint (0) 0.0%

Survey Gizmo (0) 0.0%

Other (21) 11.5%

Full details of ‘other’ answers can be found in appendix 4.

*17 respondents (9.3%) replied ‘Don’t know’ and 2 (1.1%) did not reply. Of the

remaining 163:

0-20% (41) 25.1%

21-40% (53) 32.5%

41-60% (33) 20.2%

61-80% (21) 12.9%

81-100% (15) 9.2%

*92 respondents (50.5%) replied ‘Don’t know’ and 7 (3.8%) did not reply. Of

the remaining 83:

0-20% (63) 75.9%

21-40% (14) 16.9%

41-60% (5) 6.0%


Q8. In your opinion, which are the more effective at improving patient care?

Q9. How is clinical audit managed in your organisation? (e.g. data entry/analysis).

Q10. To your knowledge or best approximation, what proportion of local clinicalaudits initiated in your organisation result in a re-audit being carried out?

Q11. To your knowledge or best approximation, what proportion of local clinicalaudits initiated in your organisation result in a financial cost saving (after timespent conducting the audit project has also been accounted for)?

61-80% (1) 1.2%

81-100% (0) 0.0%

As a supplementary question (Q11b) asked respondents to identify a local audit

project that had led to a cost saving.

As a footnote to Q11, of the 20 respondents who rated their cost saving rate for

local audits above 21% only 8 (40%) were able to specify a local audit project

that had resulted in a cost saving.



HQIP website (150) 82.4%

CASC e-Newsletter (148) 81.3%

HQIP e-bulletin (140) 76.9%

Local/regional clinical audit meetings (125) 68.7%

NICE website (121) 66.5%

CASC website (108) 59.3%

National Clinical Audit Forum (85) 46.7%

CASC e-journal (66) 36.3%

NAGG website (37) 20.3%

NCAAG webpages (27) 14.8%

Online journal of clinical audits (22) 12.1%

Other (9) 4.9%

Of those that stated ‘other’ the specific replies were: ‘clinical and professional

magazine, e.g. Ambulance UK, Nursing Standard, BMJ, Professional Manager,

etc’, ‘Help the Hospices National Audit Tools Group’, ‘HQIP events’, ‘SCIE’, ‘local

network’ and ‘networking’.


More resources available to support audit (19) 10.5%

Fewer resources available to support audit (80) 44.2%

Resources for audit have not altered significantly (82) 45.3%


Q12. Which of the following do you use to keep up-to-date with what is happeningin the world of clinical audit?

Q13. Over the last 12 months, what change has there been in the way clinicalaudit is resourced in your organisation?

A total of 122 clinical audit professionals completed the online survey and this

section of the report looks at the results specific to them.

Answers ranged from 1 year (6 responses) to 20 years (4 responses). 4

respondents did not reply to this question. Further analysis showed the mode

result was 10 years (with 16 respondents).

Results by age banding were as follows (n=118):

1-5 years (41) 34.7% -2.2%

6-10 years (42) 35.6% +3.8%

11-15 years (16) 13.6% -2.3%

16 years or more (19) 16.1% +0.8%

Acute Care (56) 45.9% -3.6%

Ambulance Trust (7) 5.7% +1.3%

Mental Health (17) 13.9% -2.6%

Primary Care (23) 18.9% -2.5%

Other (19) 15.6% +0.2%

*A total of 19 respondents (15.6%) did not reply as they noted that ‘I did not

work in clinical audit in 2006. Of the remaining 103:

More Positive (60) 58.3% -0.9%

More Negative (14) 13.6% +1.8%

Neither positive/negative (29) 28.2% -0.7%


Yes (90) 74.4% -0.7%

No (31) 25.6% +0.7%


Results by Clinical Audit Professional Only

Q2. How long have you worked in clinical audit?

Q3. What sector do you work in? (n=122):

Q4. In 2006, the Chief Medical Officer stated a need to ‘reinvigorate clinical audit’.With this in mind, do you now feel more positive or negative about audit in 2006?

Q5. Do you still intend to work in clinical audit/or have responsibilities for clinicalaudit in five years’ time?

*14 (11.5%) respondents stated ‘I have not taken part in National Clinical

Audits’. Of the remaining 108:

Excellent (5) 4.6% -1.7%

Good (35) 32.4% -3.0%

Moderate (54) 50.0% +3.1%

Poor (13) 12.0% +1.2%

Very Poor (1) 0.9% +0.3%

The following NCA’s gained at least 3 votes specifically from clinical audit

professionals:




Prescribing in Mental Health Services (POHM) 4

National Hip Fracture Database 3

National IBD Audit 3

The following NCA’s gained at least 3 votes specifically from clinical audit

professionals:



Diabetes Audit 3



Head and Neck Cancer (DANHO) 3

*10 (8.2%) of those surveyed did not reply. Of the remaining 112:

Local audits (89) 79.5% +1.1%

National audits (23) 20.5% -1.1%


Q6. Overall, how would you rate the quality of National Clinical Audit projects thatyou have taken part in?

Q7a. What do you consider to be the most effective national audit?

Q7b. What do you consider to be the least effective national audit?

Q8. In your opinion, which are the more effective at improving patient care?



Excel (115) 94.3% -0.2%

Access (66) 54.1% +3.6%

Snap (33) 27.0% +5.0%

Formic (26) 21.3% +2.6%

SPSS (21) 17.2% +0.2%

Survey Monkey (19) 15.6% -0.3%

Teleform (8) 6.6% +/-0%

Keypoint (6) 4.9% +1.1%

CRT Viewpoint (0) 0.0% +/-0%

Survey Gizmo (0) 0.0% +/-0%

Other (14) 11.5% +/-0%


remaining 111:

0-20% (26) 23.4% -1.7%

21-40% (36) 32.4% -0.1%

41-60% (22) 19.8% -0.4%

61-80% (18) 16.2% +3.3%

81-100% (9) 8.1% -1.1%


remaining 52:

0-20% (37) 71.1% -4.8%

21-40% (11) 21.2% +4.3%

41-60% (4) 7.7% +1.7%

61-80% (0) 0% -1.2%

81-100% (0) 0% +/-0%


Q9. How is clinical audit managed in your organisation? (e.g. data entry/analysis).

Q10. To your knowledge or best approximation, what proportion of local clinicalaudits initiated in your organisation result in a re-audit being carried out?

Q11. To your knowledge or best approximation, what proportion of local clinicalaudits initiated in your organisation result in a financial cost saving (after timespent conducting the audit project has also been accounted for)?



CASC e-Newsletter (106) 86.9% +5.6%

HQIP website (105) 86.1% +3.7%

HQIP e-bulletin (102) 83.6% +6.7%

Local/regional clinical audit meetings (90) 73.8% +5.1%

CASC website (81) 66.4% +7.1%

NICE website (79) 64.8% -1.7%

National Clinical Audit Forum (69) 56.6% +9.9%

Clinical Audit Today (54) 44.3% +8.0%

NAGG website (27) 22.1% +1.8%

NCAAG webpages (18) 14.8% +/-0%

Online journal of clinical audits (18) 14.8% +2.7%

Other (8) 6.6% +1.7%


More resources are available to support audit (12) 9.9% -0.6%

Fewer resources are available to support audit (54) 44.6% +0.4%

Resources for audit have not altered (55) 45.5% +0.2%

The Clinical Audit Support Centre, consider that the results of this survey provide

an accurate picture of the state of clinical audit at the time when the data was

collected (December 2010). We acknowledge that there are limitations to the

survey and the response rate could have been higher. We also acknowledge that

some responses in relation to the work of the Clinical Audit Support Centre in

Q12 may record inflated results given that respondents to the survey were

reporting back to the Clinical Audit Support Centre. In addition, it should be

noted that results for most and least effective national audits may be skewed

owing to the fact that acute sector respondents represented 42.3% of all

participants in the survey.

Despite a number of small limitations, the survey was conducted confidentially

and 182 respondents completed the online questionnaire. All results were

feedback to and analysed by an independent organisation with no vested

interests in national audits and the completeness of responses was excellent

with few questions skipped or omitted.

The response to the findings of the survey has been promising and within a


Q12. Which of the following do you use to keep up-to-date with what is happeningin the world of clinical audit?

Q13. Over the last 12 months, what change has there been in the way clinicalaudit is resourced in your organisation?

Conclusions

month of publishing interim results, Professor Nick Black (Chair of the National

Clinical Audit Advisory Group) was presenting data from the study at the national

clinical audit conference in London. Indeed, results of the survey have gained

widespread interest and CASC have presented data at national meetings (e.g.

the National Audit Governance Group in September 2011) and regional

meetings (e.g. South and East London Clinical Audit Network in September

2011). The draft report was tabled and discussed at the National Clinical Audit

Advisory Group meeting in September 2011 (which includes representation from

the Department of Health) and numerous clinical audit/governance

professionals have requested copies of the document.

In Autumn 2011, the Clinical Audit Support Centre circulated the draft report to

the key bodies with a responsibility for clinical audit and requested feedback. It

is disappointing to note that none was received. However, it is clear that the

survey has had an impact at many levels and it is not surprising that on 12th

December 2011 the Healthcare Quality Improvement Partnership announced

that the National Continence Audit (voted the least effective national audit by

27 survey respondents) is undergoing significant revision.

In terms of picking out key findings from the survey, this is not easy given the

significant amount of data obtained. However, the Clinical Audit Support Centre

would draw attention to the following:

• Despite the continued expansion of the national audit programme, those

working in clinical audit are clear that local audit (not national) is a more

effective tool for improving patient care

• National clinical audits continue to divide opinion. Given the huge

financial resources national audits devour each year and considering the

time they take local teams to conduct, the fact that 46.9% of respondents

rated them as ‘moderate’ is hugely concerning

• Results of the survey clearly show that resourcing for clinical audit is

decreasing. This is not surprising given the current financial climate but

it is concerning when one reflects that clinical audit is apparently

undergoing a phase of ‘re-invigoration’

• The study shows that more attention needs to be paid to re-auditing.

Figures indicate the majority of respondents reported a re-audit rate of

40% or less. Given that re-audit is essential if the benefits of any given

clinical audit project are to be realised, efforts must be made to improve

re-audit rates for both local and national clinical audits

• The vast majority of current clinical audits do not result in cost savings.

Furthermore, most respondents do not evaluate whether their audits save

money and therefore more debate is required here.

On a final note, the Clinical Audit Support Centre would like to draw your


attention to the fact that the online survey will be repeated in December 2011.

Results and findings of the follow-up survey will be published in Spring 2012

and we consider that the second survey may prove more beneficial than the first

given that we will be in a position to compare results from 2010 with results

from 2011.

Acknowledgements

The Clinical Audit Support Centre would like to pay thanks to:

1) Snap Surveys for providing the online software support

2) All those who took time to complete the online survey as well as those

who encouraged others to take part

Information on the appendix:

All comments listed in the report from this point onwards are printed as they

were received. We have not altered comments from those who took part in the

survey, hence some typos and spelling mistakes will appear from time to time.

For ease, the comments have been placed in alphabetical order.


Appendix 1:

Further responses for those who replied ‘other’ when asked to define their sector

of work:

• ALB (i.e. arms length business)

• All the above (i.e. primary, acute, mental health and ambulance)

• Community Health Service (x2)

• Community provider

• Cross-sector audit

• Hospice (x2)

• I am responsible for clinical audit in the commissioner, community

services and acute sector

• Local Health Board – both primary, acute and mental health care

• Blood and Transfusion (x2)

• Our organisation is unique in that it encompasses all these sections in

one PCT – both provider and commissioner

• Offender health

• PCT (x2)

• Primary care, community services, commissioning, public health

• Provider Services

• Rheumatology/secondary care

• Royal College

• Secondary care

• SHA

• Tertiary specialist care

• Tertiary specialist hospital


Appendix 2: Answers to ‘Most Effective’ NCA:

All Royal College of Psychiatrists projects

Ambulance Services still have little direct involvement in many of the Natioanl

Audit Projects. The one which has the most impact is MINAP, and even though

we do not directly contribute data I feel this is an effective national project which

has demonstrated real improvements in care over the years

Any NBS audit has usually proved beneficial, clear audit criteria are set to

measure performance against. In fact any audit that has clear, evidence based

audit criteria will be effective as they show up all strengths and weaknesses

Audits carried out by the Royal College of Physicians tend to be good e.g National

IBD audit

Because of the nature of its services, this Trust only participates in the National

Falls and Bone Health Audit. It is difficult to say how much the audit has affected

services given the extent of general service redesign as a result of NHS

organisational churn in the last 3 years. It is almost certainly helpful in

ascertaining the national overview

Bowel

Cannot comment do not have to complete national audit

Comparative Audit of Blood Transfusion

Continence

Dementia (x2)

Diabetes (x2)

Don't know

Falls (x4)

Falls and Bone Health (x2)

Falls and Bone

Falls in bone health

Falls in elderly

Have not been involved


I am not currently involved in nationla clinical audits

I dont deal with the National Audits

I was involved with the pilot of the controlled drugs audit as a result of the Harold

Shipman events. It was an excellent audit with some very good

recommendations as a result

IBD

IBD or care of the dying

MINAP (x11)

MINAP in its early days

MINAP – Myocardial Infarction National Audit Project

Most effective so far is the NAPT although this hasnt quite finsihed

N/A I haven't personally been involved with any national audits

National audit of falls and bone health in older people PROMS

National Audit of Violence (x3)

National Continence Audit

National Diabetes Audit

National Falls & Bone Health

National Hip Fracture Database (x3)

National intermediate care audit pilot

National Sentinal Stroke Audit

National Sentinel Audit for Stroke

National Sentinel Stroke Audit (x2)

National Sentinel Stroke Audit - do actually see improvements

National stroke - only because it has got attention for a 'Cinderella' service over

many years not because I think the information analysis is robust or the data

submitted is reliable


National Stroke & Continence National Audit

National Stroke Audit

NBOCAP - National Bowel Cancer Audit Project

NCEPOD (x2)

NICE audit standards monitoring

No taken part

None (x2)

Not sure - haven't often been privy to any changes implemented after results

are published

Not undertaken sufficient number of national audits to have an opinion

POMH UK (x2)

POMH-UK audits

POMHS

Prescribing in mental health services

Prescribing Observatory for Mental Health national benchmarking projects

RCP National Falls Audit

Relatively few applicable to tertiary cancer care - value often comes from

knowing we compare well with other providers

Reperfusion - adminstration of thrombolysis for MI patients (Call to Needle) as

it encourages cross disciplinary working, individual case investigation and

providing information that steered future care and improvements in treatment

Sentinel

Sentinel Stroke (x3)

Sentinel Stroke Audit (x3)

Sentinel stroke audit. It is multidisciplinary with clear standards and has moved

stroke care forward in defining areas of both good practice and that need more

attention


Sentinel Stroke Audit - it's not easy or intuitive to collect the data and complete

the forms, but they do get excellent participation rates and it does seem to have

resulted in real change and improvement in the management of stroke in this

country - at least in the early yesrs - possibly this has wained a little in recent

times

Staff survey

Stroke (x8)

Stroke audit

Stroke care

Stroke, National Neonatal Audit Programme

Suicide Prevention - NPSA

The best National Audits are the ones that report back with usable information

to Trusts to enable positive change

The Kidney programme

The most effective is probably the national audit of continence care led by the

Royal College of Physicians. It has been promoted well and the support received

from the RCP was great. It is high on the agenda in my organisation and actions

to address issues are in place

The national audits I refer to are based on tools developed by the National Audit

Tools Group of Help the Hospices. All tools are extremely effective

With reference to Wales it would be Sentinel Stroke - it took several rounds but

the national status it has now achieved, is as a result of the persistent reporting

of the national audit

1000 Lives Campaign (Wales)


Appendix 3: Answers to ‘Least Effective’ NCA:

All national databases, eg MINAP, ICNARC and the like. Data collection exercises

that may highlight good practice elsewhere but clinicians hide behind the report

(and sometimes don't even share the results) and the fact that 'we' are taking

part so therefore change is not required

All Royal College of Physicians projects

All those that are data counting exercises

Any of the national audits that aren't really audit - just data collection!

Any of the National Patient Experience Surveys - no one accepts ownership for

the results and taking and action plan forward

BTS Audits badly designed

Can't say although previous national falls audit reporting has led to 'accurate'

but very misleading reporting because of the way it was set up (also true of

stroke reporting) which I find counter productive and undermines my confidence

in their use

Cancer audits

Cancer databases, e.g. LUCADA, DAHNO

Clinical Performance Indicators for Ambulance Trusts as these are only snapshot

audits and although encourage local improvement through benchmarking

becomes more of a measure of documentation compliance rather than focusing

on improving why clinical care not given

Continence (x12)

Continence audit (x2)

Continence Care (x5)

Continence in primary care

DAHNO - Data for Head & Neck Oncology

Dementia (x2)

Diabetes

Diabetes Inpatient Audit


Don't know

Emergency medicine audits

Ethnic census

Falls (x2)

Falls and bone health in older people (x2)

Falls and bone health

Falls/Continence

GP

Healthcare Commission Schizophrenia audit 2008 took too long to be reported

on

I am not currently involved in nationla clinical audits

I am not sure

I dont deal with the National Audits

IBD (x2)

Incontinence

Inpatient Diabetes - proper permissions we not achieved prior to undertaking

the audit and organisations did not recieve the feedback promised at the outset.

National audits take a substantial local resource and effort to undertake,

effective outcome reporting is paramount

Inpatient survey

Least effective was the National Audit of Continence Care

MINAP

Minap, Falls

Minap. Massive, problematic, data collection exercise that produces much stress

and no constructive feedback

N/A I haven't personally been involved with any national audits

National audit of Continence


National audit of depression

National Continence

National Continence Audit

National Diabetes Audit (x2)

National Falls & Bones

National Heart Failure Audit

National Sentinel Stroke audit

NCEPOD (All, never complete audit cycle, very low participation rates)

No opinion

No view

None (x2)

Not known

Not sure - haven't often been privy to any changes implemented after results

are published

Not undertaken sufficient number of national audits to have an opinion

Parkinsons Disease

Patient Survey

POMH

RCP - Proctologists project which was never reported, allegedly because the

results were so bad

RCP Continence

RCP-National Falls & Bone Health

Relatively few applicable to tertiary cancer care - DAHNO is particularly complex,

ill-thought out and inflexible

Schizophrenia (x2)


SCTS Thoracic - a huge data collecting exercise, that seems to give very little

information back - and only a few trusts participate in it. The same could be

said for several of the CCAD run audits

Sentinel Audit of Stroke

Some of the BTS audits as the turnaround for the audits are too quick not

allowing changes to be implemented

Stroke

Suicide

Surgical site surveillance (HPA)

The initial national diabetes audit project

Thoracic surgery register

Tissue Viability Audit seemed to fall flat on its face!

Unknown

Unsure

We have participated in a number of Oncology audits from the Royal College of

Radiologists over the last 2 years and to date have not recieved any reports!


Appendix 4:Qualitative responses to ‘other’ IT used:

• Epi

• Epi Info

• For Enhancing Quality we use the Quality Measures Reporter software

• Infoflex

• Lime survey

• Manual

• Minitab

• Miscrosoft SharePoint

• Most of our data is collected in either Intellect or Infoflex. We also use

chartrunner to run spc charts for many projects

• Optimum - we are unfortunately about to lose Formic due to economic

constraints

• Remote extraction of data from GP systems

• Quasar

• SAS

• SharePoint to Excel or Access

• Sphinx (2)

• Starting to develop info path - does seem to be as easy as survey monkey

• Through trust

• We don't collect data

• Word


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