Institutional use of National Clinical Audits by healthcare providers

Lynn McVey, Natasha Alvarado, Justin Keen, Joanne Greenhalgh, Mamas A Mamas, Christopher Gale, Patrick Joseph Doherty, Richard Feltbower, Mai Elshehaly, Dawn Dowding, Rebecca Randell

Research output: Contribution to journalArticlepeer-review


Rationale, aims, and objectives
Healthcare systems worldwide devote significant resources towards collecting data to support care quality assurance and improvement. In the United Kingdom, National Clinical Audits are intended to contribute to these objectives by providing public reports of data on healthcare treatment and outcomes, but their potential for quality improvement in particular is not realized fully among healthcare providers. Here, we aim to explore this outcome from the perspective of hospital boards and their quality committees: an under‐studied area, given the emphasis in previous research on the audits' use by clinical teams.

We carried out semi‐structured, qualitative interviews with 54 staff in different clinical and management settings in five English National Health Service hospitals about their use of NCA data, and the circumstances that supported or constrained such use. We used Framework Analysis to identify themes within their responses.

We found that members and officers of hospitals' governing bodies perceived an imbalance between the benefits to their institutions from National Clinical Audits and the substantial resources consumed by participating in them. This led some to question the audits' legitimacy, which could limit scope for improvements based on audit data, proposed by clinical teams.

Measures to enhance the audits' perceived legitimacy could help address these limitations. These include audit suppliers moving from an emphasis on cumulative, retrospective reports to real‐time reporting, clearly presenting the “headline” outcomes important to institutional bodies and staff. Measures may also include further negotiation between hospitals, suppliers and their commissioners about the nature and volume of data the latter are expected to collect; wider use by hospitals of routine clinical data to populate audit data fields; and further development of interactive digital technologies to help staff explore and report audit data in meaningful ways.
Original languageEnglish
Number of pages8
JournalJournal of Evaluation in Clinical Practice
Early online date20 Apr 2020
Publication statusE-pub ahead of print - 20 Apr 2020

Bibliographical note

© 2020 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd

Cite this