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Understanding Audit (Clinical Governance Advice No. 5)


Clinical audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Aspects of the structure, processes and outcomes of care are selected and systematically evaluated against explicit criteria. Where indicated, changes are implemented at an individual, team or service level and further monitoring is used to confirm improvement in healthcare delivery.

Clinical governance provides a framework for accountability and quality improvement. While research is concerned with discovering the right thing to do, audit is concerned with ensuring that the right thing is done.

As good medical practice, individual doctors are required to undertake clinical audit, and NHS trusts are required to ensure that hospital doctors take part in national clinical audits, confidential enquiries and audit programmes endorsed by the Commission for Health Improvement (CHI). Obstetricians and gynaecologists therefore need to understand the principles of clinical audit.

In this document, the issues surrounding audit methodology, organisation and implementation of change are discussed.

COVID disclaimer

This Clinical Governance Advice was developed prior to the emergence of the COVID-19 coronavirus.

Version history

This is the first edition of this guidance.

Please note that the Patient Safety Committee regularly assesses the need to update. Further information on this review is available on request.

Developer declaration of interests

Available on request.