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National clinical audits (NCAs) provide a key stimulus to improve the quality of clinical care in the NHS in England. They now cover about 60 conditions or interventions, with more being established each year. Since 2010, Trusts have been encouraged to take part by a requirement to report their participation in NCAs in their annual Quality Account. To determine whether this incentive is encouraging greater participation, we have reviewed the Quality Accounts 2011 of the same 50 randomly selected acute Trusts that we studied in 2010.1
Unlike in 2010 when three Trusts provided no information on NCAs, they all met this requirement in 2011. Of the 54 NCAs recommended by the Department of Health, on average a Trust was eligible to participate in 44 (median; mean 42.2) of which they participated in 33 (median; mean 30.3). There was no association with Foundation status but university-associated Trusts reported higher participation (80%) than others (68%). As in 2010, most Trusts participated in 60-90% of NCAs for which they were eligible. While the overall rate of participation in the 54 NCAs was 72%, little changed from 2010 (69%), there were signs of less variation with only seven Trusts below 60% compared to 17 in 2010.
The principal reason given by Trusts for not participating in an NCA was a lack of resources for data collection, though a few mentioned being unaware of the existence of a NCA and some questioned the value of participating. Compared to the previous year, Trusts cited more examples of how the results of NCAs had been used to stimulate quality improvement through service redesign.
Overall, there is some evidence that Trusts historically less likely to participate in NCAs may have responded to the introduction of Quality Accounts, though other factors may have also contributed.
Reference
1. Black N, Nossiter J. Reporting national clinical audits in quality accounts. Brit J Healthcare Management 2011;17(2):75-9.
Competing interests:
NB chairs the DH National Clinical Audit Advisory Group that advises the Department opfHealth in England on policy for clinical audit
Re: Death rates from lung cancer surgery have almost halved over 10 years
National clinical audits (NCAs) provide a key stimulus to improve the quality of clinical care in the NHS in England. They now cover about 60 conditions or interventions, with more being established each year. Since 2010, Trusts have been encouraged to take part by a requirement to report their participation in NCAs in their annual Quality Account. To determine whether this incentive is encouraging greater participation, we have reviewed the Quality Accounts 2011 of the same 50 randomly selected acute Trusts that we studied in 2010.1
Unlike in 2010 when three Trusts provided no information on NCAs, they all met this requirement in 2011. Of the 54 NCAs recommended by the Department of Health, on average a Trust was eligible to participate in 44 (median; mean 42.2) of which they participated in 33 (median; mean 30.3). There was no association with Foundation status but university-associated Trusts reported higher participation (80%) than others (68%). As in 2010, most Trusts participated in 60-90% of NCAs for which they were eligible. While the overall rate of participation in the 54 NCAs was 72%, little changed from 2010 (69%), there were signs of less variation with only seven Trusts below 60% compared to 17 in 2010.
The principal reason given by Trusts for not participating in an NCA was a lack of resources for data collection, though a few mentioned being unaware of the existence of a NCA and some questioned the value of participating. Compared to the previous year, Trusts cited more examples of how the results of NCAs had been used to stimulate quality improvement through service redesign.
Overall, there is some evidence that Trusts historically less likely to participate in NCAs may have responded to the introduction of Quality Accounts, though other factors may have also contributed.
Reference
1. Black N, Nossiter J. Reporting national clinical audits in quality accounts. Brit J Healthcare Management 2011;17(2):75-9.
Competing interests: NB chairs the DH National Clinical Audit Advisory Group that advises the Department opfHealth in England on policy for clinical audit