GP mythbuster 4: Quality improvement activity

Page last updated: 23 December 2022
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We have updated and republished this mythbuster to highlight the range of quality improvement activity of which clinical audit is an example.

Practices should routinely review the effectiveness and appropriateness of the care provided in order to provide effective, safe care.

We are working with the General Medical Council, NHS England and the Royal College of General Practitioners to reduce the workload associated with regulation. This is particularly relevant for quality improvement activity where the information that we request can be used for multiple purposes, including individual professional revalidation.

Clinical audit

There are many different types of quality improvement activity (QIA), one example is clinical audit.

This is a process or cycle of events that helps ensure patients receive the right care and treatment. Care and services are measured against evidence base standards and changes are implemented to narrow the gap between existing and best practice. Ideally, a clinical audit is a continuous cycle that is continuously measured with improvements made after each cycle.

The Royal College of General Practitioners has practical guidance for quality improvement.

Other examples of QIA

These include:

  • review of outcomes data
  • small scale data searches
  • information collection and analysis (Search and Do activities)
  • plan/do/study/act (PDSA) cycles
  • significant event analysis (SEA)
  • large scale national audit
  • reflective case reviews
  • reflection on formal patient and colleague feedback survey results.

What do we look for in an inspection?

During an inspection, we are looking for evidence that QIA is being undertaken. This can come from written records and discussions with staff. This comes under key line of enquiry E2: how are people’s care and treatment outcomes monitored and how do they compare with other similar services?

Practices should be able to demonstrate they:

  • consider the quality of care provided
  • review the care provided in relation to current best practice guidance
  • make changes where necessary or appropriate in order to improve
  • revisit the question to see whether the changes made have resulted in an improvement.

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