1. Delivering National Clinical Audit The Barts Health Approach Emerald Toogood Project Lead

2. Content People and practice Our approach to learning from clinical audit Our approach to obtaining data for clinical audit Our approach to outlier investigations Sharing clinical audit with stakeholders

3. Context Over 15,000 staff More than six sites Our vision and values: Relentlessly improving and innovating for patient safety Achieving ambitious results by working together Valuing every member of staff and their contribution to the care of our patients

4. People Central Clinical Effectiveness Unit sits within the Business Intelligence Unit Clinical Effectiveness Leads in each specialty plan the specialty audit programme Lead Clinician Junior Doctor Administrator (eg MDT Coordinator)

5. Specialty programme Local projects, informed by national audit project results/design Caveat: areas with high volume of national audit activity (eg BTS) are local priorities being addressed? Presentation date

6. Committee review – the content First committee meeting within one month of the report publication Second committee meeting when all actions have been achieved

7. Policy Participation in national clinical audit is a Barts Health priority agreed by the Trust Board ‘National clinical audit and management of outliers’ policy in addition to local audit policy, incorporates Roles and responsibilities (eg registration, both with the supplier and internally) Information governance Data quality Personal development Service improvement principles Outlier management Sharing good and bad news

8. Data sources Access to paper records Identifying patients for clinical audit Using CRS-derived data - improving data quality and completeness - getting the diagnoses and problems right for each patient.

9. Collaboration platform

10. Outlier investigation Who undertakes the investigation Checking data, including date of death, age, sex, disease severity, co-morbidity Global trigger tool Use of routinely available data, risk management systems, clinical due diligence

11. Key points Bring the right people together to better understand their service Make sure that the team knows what to do and when Simultaneously improve data quality and completeness Use local audit to complement the national audit programme, not forgetting local priorities Use national audit data in conjunction with routinely available data – a key element of letters of representation and due diligence