Clinical Governance and Audit in NHS
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Questions and Answers

What is the primary purpose of clinical audit in the NHS?

  • To inspect and examine entire organisations
  • To audit documents, risk, or performance
  • To continuously improve the quality of services and safeguard high standards of care (correct)
  • To follow up on completed corrective actions

    • What is the definition of an audit according to ISO 19011:2018?

  • A method to ensure efficient use of resources
  • A way of doing the right things right, to the right people at the right time
  • A systematic, independent, and documented process for obtaining audit evidence (correct)
  • A tool to improve patient care and support change

    • What is the primary goal of standard operating procedures (SOPs)?

  • To provide accurate instructions on how to perform a defined process (correct)
  • To ensure efficient use of resources
  • To audit documents, risk, or performance
  • To support change and improve patient care

    • Where can clinical audits take place?

    <p>In community pharmacies, hospital pharmacies, aseptic units, and GP practices</p> Signup and view all the answers

    What is the relationship between clinical governance and clinical audit?

    <p>Clinical audit is a tool for clinical governance</p> Signup and view all the answers

    What is the outcome of a clinical audit?

    <p>An evaluation of the extent to which audit criteria are fulfilled</p> Signup and view all the answers

    What is the recommended standard for prescribing NSAIDs to elderly patients with Cardiovascular Disease?

    <p>Twenty percent</p> Signup and view all the answers

    In the clinical audit, what is the recommended standard for prescribing ibuprofen or naproxen to elderly patients?

    <p>Eighty percent</p> Signup and view all the answers

    Why are NSAIDs contraindicated in elderly patients with Heart Failure?

    <p>Due to the risk of cardiovascular and gastrointestinal effects</p> Signup and view all the answers

    What is the main objective of conducting a clinical audit on NSAID prescribing in elderly patients?

    <p>To evaluate and improve the safe use of NSAIDs in elderly patients</p> Signup and view all the answers

    In the clinical audit, what is the age range defining 'elderly patients'?

    <p>75 years and over</p> Signup and view all the answers

    How many clinical audits must Pharmacy Contractors undertake per year?

    <p>Two</p> Signup and view all the answers

    What is the primary purpose of eliminating variations in processes?

    <p>To eliminate variations in processes which need to be completed the same way every time</p> Signup and view all the answers

    What is the main difference between clinical audit and quality management?

    <p>Clinical audit is a quality improvement process, while quality management is a quality assurance process</p> Signup and view all the answers

    What is the first step in the clinical audit cycle?

    <p>Decide on a topic</p> Signup and view all the answers

    What is the purpose of setting a standard of care expected?

    <p>To set criteria and standards for care</p> Signup and view all the answers

    What type of data is routinely reported by NHS services?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of data analysis in the clinical audit cycle?

    <p>To present data so that it can be compared to the standard</p> Signup and view all the answers

    What is the purpose of making recommendations in the clinical audit cycle?

    <p>To identify areas for improvement</p> Signup and view all the answers

    What is the final step in the clinical audit cycle?

    <p>Re-audit</p> Signup and view all the answers

    What is the role of pharmacists in clinical audit?

    <p>To participate in clinical audits in community pharmacy, hospital pharmacy, and primary care/public health pharmacy settings</p> Signup and view all the answers

    What is the purpose of clinical audit in pharmacy settings?

    <p>To improve patient care and outcomes</p> Signup and view all the answers

    What is the primary purpose of clinical audit in the NHS?

    <p>To improve patient care by identifying areas for improvement</p> Signup and view all the answers

    What is the main purpose of standard operating procedures (SOPs)?

    <p>To ensure consistency and standardisation in processes</p> Signup and view all the answers

    What is the primary goal of clinical governance?

    <p>To improve patient care by ensuring high standards of care</p> Signup and view all the answers

    What is the primary outcome of a clinical audit?

    <p>Improved patient care</p> Signup and view all the answers

    What is the definition of an audit?

    <p>A systematic, independent and documented process for obtaining audit evidence and evaluating it objectively</p> Signup and view all the answers

    Where can clinical audits take place?

    <p>In various settings including hospital pharmacy, community pharmacy, aseptic units, and GP practices</p> Signup and view all the answers

    What is the primary focus of the clinical audit on NSAID prescribing in elderly patients?

    <p>To evaluate the safety of NSAID prescribing in elderly patients with Cardiovascular Disease</p> Signup and view all the answers

    What is the recommended standard for prescribing NSAIDs to elderly patients with Heart Failure?

    <p>Avoid NSAIDs altogether</p> Signup and view all the answers

    What percentage of elderly patients prescribed NSAIDs should be prescribed ibuprofen or naproxen, according to the standard?

    <p>80%</p> Signup and view all the answers

    What is the frequency of clinical audits required for Pharmacy Contractors?

    <p>Two per year</p> Signup and view all the answers

    What is the nationally determined audit topic for 2021/2022?

    <p>Valproate during pregnancy</p> Signup and view all the answers

    Where can Pharmacy Contractors find resources and examples for clinical audits?

    <p>On the PSNC and RPS websites</p> Signup and view all the answers

    What is the primary focus of clinical audit in pharmacy settings?

    <p>Improving patient care and outcomes</p> Signup and view all the answers

    What is the purpose of setting standards of care expected in clinical audit?

    <p>To measure care against specific criteria</p> Signup and view all the answers

    What type of data may pharmacy contractors need to collect for clinical audit?

    <p>All of the above</p> Signup and view all the answers

    What is the outcome of a clinical audit cycle?

    <p>Improved patient care and outcomes</p> Signup and view all the answers

    What is the role of pharmacists in clinical audit?

    <p>To participate in the audit cycle to improve patient care</p> Signup and view all the answers

    What is the purpose of oversight in clinical audit?

    <p>To ensure quality assurance</p> Signup and view all the answers

    What is the relationship between clinical governance and clinical audit?

    <p>Clinical audit is a subset of clinical governance</p> Signup and view all the answers

    What is the purpose of making recommendations in clinical audit?

    <p>To implement changes to improve care</p> Signup and view all the answers

    What is the primary focus of clinical audit in hospital pharmacy?

    <p>Any aspect of medicines use</p> Signup and view all the answers

    What is the purpose of data analysis in clinical audit?

    <p>To present data to compare with the standard</p> Signup and view all the answers

    What is the primary goal of clinical governance?

    <p>To ensure accountability for continuously improving the quality of services</p> Signup and view all the answers

    What is the purpose of an audit?

    <p>To inspect a process or quality system</p> Signup and view all the answers

    What is the purpose of standard operating procedures (SOPs)?

    <p>To ensure consistency and standardisation of processes</p> Signup and view all the answers

    Where can clinical audits take place?

    <p>In community pharmacies, hospitals, aseptic units, GP practices, etc.</p> Signup and view all the answers

    What is the purpose of tools in clinical audit?

    <p>To improve patient care</p> Signup and view all the answers

    What is the relationship between clinical governance and clinical audit?

    <p>Clinical audit is a tool for clinical governance</p> Signup and view all the answers

    At what age and above are patients considered elderly in this clinical audit?

    <p>75 years and over</p> Signup and view all the answers

    What percentage of elderly patients prescribed NSAIDs should be prescribed ibuprofen or naproxen, according to the standard?

    <p>80%</p> Signup and view all the answers

    What is the absolute contra-indication for NSAID prescribing?

    <p>Heart Failure</p> Signup and view all the answers

    How many clinical audits must Pharmacy Contractors undertake per year?

    <p>Two</p> Signup and view all the answers

    What is the topic of the nationally determined audit for 2021/2022?

    <p>Valproate during pregnancy</p> Signup and view all the answers

    What percentage of elderly patients prescribed NSAIDs with Cardiovascular Disease should be achieved, according to the standard?

    <p>20%</p> Signup and view all the answers

    What is the main purpose of clinical audit in the NHS?

    <p>To identify and improve patient care and outcomes</p> Signup and view all the answers

    What is the main focus of clinical audit in hospital pharmacy?

    <p>Anything that involves medicines</p> Signup and view all the answers

    What is the importance of setting standards of care expected in clinical audit?

    <p>To measure care against explicit criteria</p> Signup and view all the answers

    What is the role of pharmacists in clinical audit?

    <p>To participate in clinical audits and improve patient care</p> Signup and view all the answers

    What type of data may pharmacy contractors need to collect for clinical audit?

    <p>Prescribing data, patient records, and community pharmacy data</p> Signup and view all the answers

    What is the purpose of oversight in clinical governance?

    <p>To ensure quality assurance</p> Signup and view all the answers

    What is the primary outcome of a clinical audit?

    <p>To improve patient care and outcomes</p> Signup and view all the answers

    What is the main difference between clinical audit and quality management?

    <p>Clinical audit is a cycle that measures care against explicit criteria, while quality management is a broader process</p> Signup and view all the answers

    What is the purpose of data analysis in the clinical audit cycle?

    <p>To compare data to the standard and identify areas for improvement</p> Signup and view all the answers

    What is the purpose of making recommendations in clinical audit?

    <p>To improve patient care and outcomes by implementing changes</p> Signup and view all the answers

    Study Notes

    Clinical Governance and Clinical Audit

    • Clinical governance is a system that ensures NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care.
    • 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.

    Clinical Audit Cycle

    • Decide on a topic: Choose an area of practice where patient care and outcomes can be improved.
    • Set standard of care expected: Based on best evidence, specific, measurable, achievable, realistic, and relevant to the topic.
    • Data collection: Collect data to compare with the standard, using data collection tools.
    • Data analysis: Compare data with the standard, identify areas for improvement.
    • Make recommendations: Based on data analysis, make suggestions for improvement.
    • Implement changes: Take actions to improve patient care and outcomes.
    • Re-audit: Monitor and evaluate the effectiveness of changes made.

    Standard Operating Procedures (SOPS)

    • Designed to provide accurate and detailed instructions on how to perform a defined process or procedure to ensure consistency and standardisation.

    Pharmacy Contractors and Clinical Audit

    • Must undertake two clinical audits per year, chosen by the pharmacy.
    • Examples of topics: local enhanced services, prescribing audits, multi-disciplinary care.
    • Resources available on PSNC and RPS websites.

    PACT Data, Prescribing Safety, and Service Audits

    • PACT data: Prescribing Analysis and CosTs, produced by Prescription Pricing Division, details of all prescriptions dispensed in England.
    • Prescribing safety: Safe use of NSAIDs in elderly patients, following MHRA warning on cardiovascular safety.
    • Service audits: Examples include local enhanced services, prescribing audits, multi-disciplinary care.

    Pharmacist Involvement in Clinical Audit

    • Community pharmacy: NHS Contract - Essential Service requirement, topics include local enhanced services, prescribing audits, multi-disciplinary care.

    • Hospital pharmacy: Audit embedded into practice, topics include anything that involves medicines.

    • Primary care/public health pharmacy: Prescribing audits.### Clinical Audit in Community Pharmacy

    • Pharmacy contractors must undertake two clinical audits per year, with one topic chosen by the pharmacy and the other determined by NHS England.

    • Examples of topics include safe use of NSAIDs in elderly patients and flu vaccination for people with diabetes.

    Clinical Governance Requirements

    • 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.
    • The clinical audit cycle involves deciding on a topic, setting a standard of care expected, data collection, data analysis, making recommendations, implementing changes, and re-auditing.

    Setting Standards of Care Expected

    • Standards of care expected must be specific, measurable, achievable, realistic, and time-bound (SMART).
    • Standards should be based on best evidence and consist of criteria and standards.

    Data Collection and Analysis

    • Data collection involves identifying what data is needed, determining if it is readily available, and deciding how to collect it.
    • Routinely reported data may be available from sources such as PACT data, Quality and Outcome Framework, and NHS Digital.
    • Data analysis involves presenting the data to compare it to the standard and identifying areas for improvement.

    Pharmacist Involvement in Clinical Audit

    • Pharmacists can be involved in clinical audit in community pharmacy, hospital pharmacy, and primary care/public health pharmacy.
    • Topics for clinical audit may include local enhanced services, prescribing audits, and multi-disciplinary care.

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    Test your knowledge on clinical governance and audit in the NHS, including definitions and importance of quality improvement in healthcare services.

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