QI Blog: November 2020

Earlier this year, I took the decision to step off the training ladder and spend a year working as National Medical Director’s Clinical Fellow at HQIP. I’m sure many trainees can relate to the trepidation associated with taking a break from clinical medicine, especially in the midst of a global pandemic.

As a busy junior doctor, my engagement with National Clinical Audit was very limited. I had performed some data entry (at the request of my consultants), but I had no sense of the range of the audits available and the impact of these, nor (I am embarrassed to admit) had I heard of HQIP. It is safe to say that my eyes have been opened to the power of national clinical audit for quality assurance and quality improvement at a local, regional and national level.

The RCPCH oversees three HQIP commissioned national audit programmes, namely the National Neonatal Audit Programme (NNAP), National Paediatric Diabetes Audit (NPDA) and Epilepsy 12. HQIP commission a further five audits related to Child Health.  This portfolio spans a vast range of conditions, and continues to have an influential role in improving the care of children across the UK. Departments can use their data to benchmark performance against others and the national average, identify areas for improvement and learn from successes.

Certainly, audit data alone does not lead to improvement. However, it is important to recognise that this data is key to building a case for change, at departmental, regional and national level. The RCPCH Epilepsy Quality Improvement Programme (EQIP) exemplifies how national clinical audit data can be used to drive quality improvement. This programme goes beyond publishing audit reports, acting to support clinical teams to use their audit data to develop suitable interventions and drive sustainable improvement in their services.

Just as continuous improvement is needed in clinical environments, there is undoubtedly room for improvement for national clinical audit programmes to reach their full potential. I believe increasing awareness and engagement with the audit programme amongst junior clinicians is a key area for improvement. Active involvement with national clinical audit processes, allows for learning about audit methodology, principles of quality improvement and the complexities of these in clinical practice. Embedding this into the day to day practice of junior clinicians is important for driving relevant and sustainable change.

Suffice to say, I have no regrets about taking a year out of training. Seeing healthcare through a different lens has brought rich learning and I’m confident that the lessons from this year, particularly with regards to audit and QI, will make me a better clinician.

Dr. Hannah Wright

National Medical Director’s Clinical Fellow working at HQIP

Watch Hannah’s presentation on her work looking at awareness and engagement with the National Clinical Audit and Patient Outcomes Programme among trainee doctors hosted by HQIP in July 2021 below: