ABSTRACT
This chapter defines clinical audit and outlines its evolution within the NHS in the UK. Some suggestions for organising clinical audit within the directorate are made and an explanation given of the recently published clinical audit assessment framework which can be used to help improve the effectiveness of audit. Formal clinical audit was introduced in an attempt to address several important issues that had become a cause for concern during the 1970s and 1980s. First was the growing realisation that results of clinical research were not promptly translated into everyday practice. Second was the awareness that there was great variation in practice in the management of common conditions, from the vastly different rates of hospital referral by general practitioners, to widely different approaches to the management of common cancers. Third there was need to attempt to control the increasing costs of health. Different ways of managing patients led to differing costs; for example, different rates of day-case surgery.
