Fabulous response to CASC survey
We would like to thank all those who took the time and made the effort to contribute to our seventh annual clinical audit survey during December. A record total of 218 respondents completed the survey, a significant uplift on our previous record total of 182 achieved in 2010 and 2015. As in previous years the majority of respondents were from an acute setting with 57% describing themselves as a ‘clinical audit professional’. This year we extended the survey to include more questions on national clinical audit and we have had a great response in terms of ideas on how national audit could be improved. Given the importance of the survey, we will dedicate most of this newsletter to the interim results. A full report will be published later in 2017. Click here for the PDF containing the headline results.
A drop in positivity towards clinical audit
One of the key questions that we ask respondents of our survey to answer is the question: do you feel more positive or more negative about clinical audit than you did a year ago? The corresponding graph shows that when we first ran the survey in 2010, almost 60% of respondents answered ‘more positive’ with just over 10% answering ‘more negative’. Over the last 6 years the responses have converged and it is disappointing to report that for the first time ever in 2016, more respondents gave the response of ‘more negative’ (33.6%) as opposed to ‘more positive’ (29.4%). With the emphasis on the reinvigoration of clinical audit since 2006 this data needs to be examined in more detail.
NCAs continue to be rated as ‘moderate’
Discussions on the value, cost effectiveness and quality of national clinical audits are perennial and therefore our survey has always included a simple question asking: overall, how would you rate the quality of national clinical audit projects that you have taken part in? Results act as a litmus test for national audits, and the corresponding graph shows remarkably consistent results across all seven surveys. In every survey conducted the top answer has been ‘moderate’ with this response attaining its highest-ever rating in 2016 (55.6%). Meanwhile, the Sentinel Stroke Audit was once again rated the ‘most effective’ national audits for the seventh consecutive year, way ahead of National Emergency Laparotomy Audit in second and third placed Prescribing Observatory for Mental Health.
Great ideas for NCA improvement
For the first time in 2016 we provided respondents with the opportunity to suggest ways in which national clinical audits could be improved. We had a great response to this question with some respondents writing very detailed answers. We will categorise and feedback all answers in due course, but common suggestions included: clear standards, less extensive and cumbersome data collection, fully piloted audits prior to launch, timely reporting of results, local level data for benchmarking, high quality and user-friendly reports, more help and guidance on how to improve care following completion of the audit, etc. There was also strong support for a re-configuration of the current national audit portfolio, i.e. suggestions that there are too many NCAs for the acute sector.
Patient involvement in clinical audit
For many years now there has been an expectation that patients are increasingly involved in clinical audit. In many respects this work was pioneered by Marcia Kelson in the 1990s and she recommended lots of ways patients could be directly involved in clinical audit: selecting topics, helping set relevant standards, suggesting ideas for change, making reports patient-friendly, etc. This year in response to our question: over the last 12 months, how would you rate the level of patient involvement in clinical audits you have taken part in/facilitated, just 4 out of 218 respondents answered ‘good’. 71% answered ‘poor – patients are rarely involved in clinical audit’.
Resourcing for local clinical audit
CASC have always believed that for clinical audit to succeed at any level it is vital for investment in local clinical audit to ensure that NHS staff have access to experts who can also assist in the delivery of national audit projects. The corresponding graph indicates that for the seventh consecutive year less than 20% of respondents stated that they have ‘more resources available to support audit’ (than compared to 12 months previously). Indeed, when looking at the raw data, just 21 of our 218 respondents stated that their resources had grown in the previous 12 months. Four times as many respondents stated they had less resources compared to those stating they had more.
A message from CASC
Although we conduct the annual survey we focus on the facts and do not try to interpret the data. That said, it is clear that the results for 2016 are concerning as illustrated by the key results we have reported: less resources for local clinical audit, no improvement in the rating of the quality of national audits, few rating patient involvement in clinical audit as ‘good’ and overall positivity towards clinical audit dropping compared to previous years. We will endeavor to share the full report and complete set of results to the clinical audit community as quickly as we can. In addition, it is our sincere hope that the data gained from the 218 respondents will be used wisely by NHS England (and other stakeholders). As ever with clinical audit itself, data is key to bringing about improvement.
Sign up for accredited CASC training
New Year is always a great time to study for a new course, increase your knowledge, meet like-minded people and gain a qualification. With this in mind, all CASC courses are accredited and provide learners with the chance to gain certification that may be used for revalidation, personal development and CVs. We still have a few places on our Advanced Clinical Audit course to be held in Leicester on 17 January. In addition, learners can join our distance-learning course at any point. This course helps learners undertake a full clinical audit project with fully support from an expert tutor. For more details, please contact the CASC team.
Accredited and cost effective RCA training
Don Berwick and Sir Robert Francis have rightly stated that patient safety must be the highest priority for all providers of healthcare. With this in mind, CASC have developed an accredited one-day Root Cause Analysis course that provides learners with the key skills they will need to review patient safety incidents. In addition, we also offer accredited training in Significant Event Audit, a team-based risk management process that often takes less time to conduct than a full scale RCA. Both courses can be delivered in-house for up to 20 learners at a time. If demand is sufficient, we also offer the RCA course in Leicester. For more details on either course, please contact the CASC team.
Request your CASC information pack
CASC have developed a series of promotional materials that provides you with more details of the work that we support. The electronic pack includes information relating to: Introducing CASC, training and accreditation, support and consultancy, sharing best practice, event management and CASC case studies. The materials provide a great overview of how we work with healthcare professionals to improve the care that they deliver and there are a number of excellent case studies that show how our work has enabled organisations and teams to collaborate with us on ventures that have improved care, assured best practice and saved money. If you would like to receive your electronic copy then please email us via email@example.com
Tell your friends about our eNews
We first launched the CASC e-Newsletter in February 2007 with the aim of providing those with an interest in clinical audit and QI with a free regular monthly update. Since that time hundreds of subscribers across the world have joined our circulation list. The newsletter provides subscribers with a mixture of CASC-related and other clinical audit, quality improvement and patient safety news to help you keep up-to-date with current events. Don’t forget that if you have missed a previous issue of the newsletter then you can visit the eNews section of our website where all previous issues are archived. If you wish to sign up for your own copy or know others who may be interested then please email: firstname.lastname@example.org