Improving patient care in the UK: clinical audit in the Oxford Region.

This paper is concerned with the effectiveness of clinical audit as the principal quality control and improvement process in the UK National Health Service (NHS). The paper starts by tracing the historical development of clinical audit in the UK within the context of the major management reforms introduced within the NHS in the last ten years. The paper presents the findings of a major study of published audits within the Oxford, Four Counties and Anglia region. This study provides a snapshot of current audit practice and provides the opportunity to test the hypothesis that current practice does not reflect the stated aim of a structured investigation into the quality of patient care leading to a direct improvement in patient care. The paper considers the reasons for the discrepancy between theory and practice. It argues for the need for a structured approach to address some of these issues. The paper outlines a systematic and structured approach to clinical audit which is part of an overall programme of trying to harmonize and improve practice in audit within the Region. It concludes with plans for the future including the development of a dedicated audit tool based around a structured method.