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Audit

Audit is the process by which Primary Health Care Teams review the care they provide for their patients. By comparing what 'they do' with what is considered 'best practice' those involved can see whether the Primary Health Care Team is achieving the standards set. These standards may come from current research, new guidelines, or as a result of a complaint. Having made measurements of the quality under review any areas falling short of the standard will be revealed and can then be changed. The aim always being to improve the quality of care.

This completes one cycle of the audit process. Having made changes the process should then be re-audited to check that the changes made have indeed improved quality. This results in a continuous cycle/re-cycle process - 'a spiral'.

Audit is achieved through a systematic evaluation of the care delivered making use of one or all of the following:

    • Agreed Clinical Standards
    • Evidence Based Clinical Guidelines.
  • Systematic reviews of research findings and information on variations in clinical practice.

 It is not research. Research is concerned with discovering the 'best way' to do something whilst audit is designed to ensure that the agreed 'best way' is being implemented.

A health care system operates within a structure by a process with resulting outcomes. Listed below are some examples of the areas these three forms of audit cover.


  • Structure: resources, equipment, numbers of staff, medical record content.
  • Process: discharge planning, treatment planning, test ordering.
  • Outcome: results of care
  • Outcomes may be further divided into:
    • Clinical: complications, mortality.
    • Functional: activities of dailyliving.
    • Perceived: satisfaction, levels of understanding, knowledge.

Many doctors and Health Authorities have organised themselves to form Medical Audit Advisory Groups (MAAG). Others have different names - Primary Care Audit Groups (PCAG). Instead of looking at activity in just one Primary Health Care Team (PHCT) they encourage activity among several if not all PHCTs within the Health Authoritory boundary. An example of  an Audit Group with a website is:-

North Essex MAAG

'A small change in practice is better than a major discussion of the possibilities' 

With the coming of the new NHS, Primary Care Groups (PCGs) will have their own quality team led by a ' Clinical Governance Lead'. His role will be to develop clinical audit within the Primary Care Group.

    Audit Support Group CASG  


Organisations Involved in Setting Standards
Charter Mark
Investors in People
King's Fund
ISO 9000