UCL’s National Institute for Cardiovascular Outcomes Research (NICOR), established by Professor Sir Bruce Keogh and currently directed by Professor Sir Roger Boyle, won the contract to provide six national cardiac clinical audits. As Interim Chief Operating Officer, I led the work to ensure that:

Clinical Audit within the Hong Kong Hospital Authority

I partnered with Dr Jonathan Boyce to review the state of clinical audit across the Hong Kong Hospital Authority. Currently there are areas of good clinical audit practice, but also significant gaps. There is an appetite to do more clinical audit and potential to improve the quality and consistency of care by expanding clinical audit. The HA has an excellent standard information system that can underpin new Hong Kong-wide clinical audits. We recommended specific measures and a strategy for the reinvigoration and development of clinical audit.

National Clinical Audit and Patients’ Outcomes Programme

To meet the challenges arising from the introduction of Quality Accounts, Commissioning for Quality and Innovation and the ‘information revolution’, commissioners and service providers alike will need access to good quality information about whether services are safe and effective. The range and complexity of services offered by NHS trusts mean that there is currently no single source of such information. The National Clinical Audit and Patients’ Outcomes Programme (NCAPOP) is a set of centrally-funded national projects that provide local trusts with a common format by which to collect data that is fed back as benchmarked information, often against NICE or professional standards.

My work for several years as head of this programme means that I know about the range of audit information available, and how it can be used by trust boards as ‘headline’ indicators of quality—as well as providing very detailed feedback to individual clinicians to help them reflect on and change their practice. I also needed to work with other partner organisations offering information from audits and outcomes systems outside of NCAPOP. My comprehensive knowledge of what is available can help trusts assure themselves about whether their services reach the necessary standard of clinical quality and sensitivity to patients’ views.

Patients’ views

The NHS Constitution requires NHS services to reflect the needs and preferences of patients, their families and their carers. Every project that I undertook with the Healthcare Commission and Audit Commission included patients and representative organisations in its project governance arrangements; and measured patients views and experiences of services. For example:

Efficiency and value for money (VFM)

Improving efficiency while maintaining quality will be increasingly required in a future of ‘flat’ or even declining budgets, yet ever increasing and changing demands. I have managed the production of national VFM studies and also worked with local trusts as an auditor applying the approach. We always worked in partnership to produce realistic, achievable action plans that managers and clinical leaders could own.

Our recommendations always helped trusts save money through improved efficiency, while maintaining quality standards. For example, in relation to:

Tender assessment

I used my experience of commissioning the national clinical audit programme to help the Health Foundation select projects for its Engaging with Quality and Closing the Gap programmes.