1. Connecting BASHH National Audits to Local Audit and Practitioner Re-certification Hugo McClean Secretary BASHH National Audit Group

2. Summary questions What do UK advisory bodies say about the role of audit in Quality? What do UK professional bodies say about the role of audit in re- certification? Can the BASHH national audits provide an important (local) resource? … will be posted on BASHH website

3. –“the reinvigoration of clinical audit” –“..increase the impact that clinical audit has on healthcare quality … National advisory bodies http://www.dh.gov.uk/ab/NCAAG/index.htm http://www.hqip.org.uk/about-us/

4. Healthcare Quality Improvement Partnership National-Local Clinical Audit Seamless links between national and local audit Evidence of participation in audit, and the results of audit, used for secondary purposes. ….revalidation of healthcare professionals http://www.hqip.org.uk/local-clinical-audit/

5. UK Professional Bodies: Royal College of Nursing- Information and Knowledge 2 Information collection and analysis Core 4 Service improvement Core 5 Quality http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicy AndGuidance/DH_4090843

6. UK Professional Bodies: Clinical audit & revalidation – GMC –Revised Framework / Explanatory Note to the Framework –Derived from Good Medical Practice Royal College of Physicians –Specialty-specific Framework BASHH –In development http://www.rcplondon.ac.uk/clinical-standards/organisation/Pages/Clinical-Audit.aspx http://www.gmc-uk.org/doctors/licensing/revalidation/index.asp

7. GMC/Specialties Framework for appraisal and assessment : Domain 1 (Knowledge, Skills and Performance ) Domain 2 (Safety and Quality ) –“Participation in national or other multi-centre (e.g. regional) and local audit –“one full audit cycle … within each five-year revalidation period” –… with evidence of any practice change demonstrated by re-audit” http://www.gmc-uk.org/doctors/licensing/revalidation/gmp_framework.asp

8. BASHH National Audits Annual online audits against BASHH clinical practice standards National and regional aggregates Comparisons between clinics in regions, between regions and against national average performance Regional Audit Chairs/Groups Embrace local audit

9. National & regional aggregates

10. The Audit Cycle

11. Using the BASHH National Audits- 1 Managed the collection of data for my clinic for the BASHH 07 Audit on Management of Chlamydia Infection … processed through clinical governance Produced a data set of performance measures for our clinic Compared our performance against other clinics in the Region, and against the BASHH national guideline for chlamydial management. –only 40% of cases received written information about chlamydia –60% follow-up of cases in clinics …

12. Using the BASHH National Audits- 2 Interventions: –changed from routine follow-up of cases in clinic to telephone follow-up –led a process that found our health advisers/nurses dedicated time for telephone follow-up of chlamydial cases –produced a new proforma in our clinic, including prompts for scheduling follow- up and providing written information …

13. Using the BASHH National Audits- 3 Led re-audit of chlamydia management, using the same questions from the BASHH chlamydia audit Measured the effect of the interventions introduced aimed at improving practice and demonstrated significant improvement: –… reduced follow-up in clinics from 60% to 20%, freeing up time in clinics to see more patients –… increased our overall follow-up rate from 70% to 85%, by switching to telephone follow-up –… 60% of cases are now recorded as having received written information

14. Development of BASHH national audits Moving towards shorter, higher impact audits and re-audits Based partly on new BASHH standards for STI services (in development) Linked to revalidation/recertification

15. Summary BASHH national audits : –Embrace local audit –Connect local audit to regional and national performance and national guidelines –Provide individual clinicians with resource for re- certification & performance review Completed audit cycles needed for physician relicensure & specialist re-certification

16. Acknowledgements Chris Carne, Chair BASHH National Audit Group Mark FitzGerald, BASHH