National Audit Group

Announcements
The results of the 2011 Audit against the Key Perfomance Indicators in the BASHH & MedFASH STI Management Standards are now available on this page: see under AUDIT DATA & REPORTS AVAILABLE ON THE BASHH WEBSITE

Are you involved in clinical audit or Quality improvement in your service?- Be sure to check out the links to national Quality drivers at the bottom of this page!

The members (private content) section of the National Audit Group can be accessed here

Aims

The National Audit Group (NAG) was founded in 2003. The aims of the Group are to provide:

  • National audits of clinical practice in sexual health/genitourinary medicine clinics against the BASHH Clinical Effectiveness Group (CEG) National Guidelines
  • Questionnaire proformas for use as audit tools for the common genito-urinary conditions, using the clinical guidelines of the CEG as the standard of care
  • A forum to discuss national and regional audit programmes
  • Response to requests for national audits by the British Association of Sexual Health and HIV

The National Audit Group is a sub-group of the Clinical Governance Committee of BASHH


NAG Constitution and Terms of Reference


NAG Confidentiality Policy


MEMBERSHIP

The email addresses of Regional Audit Chairs and other Members are available to BASHH Members by clicking here.

Chair Hugo McClean
Vice Chair Chris Carne
Hon Sec Ann Sullivan
Director of Development Anatole Menon-Johansson
BCCG Representative Phil Kell
BHIVA Representative Alison Rodger, Ed Wilkins
Scotland Daniel Clutterbuck
Wales Carys Knapper
Northern Ireland Say Quah
Anglia Raouf Moussa
Cheshire & Mersey Ravindra Gokhale
Essex Gail Crowe
North Thames Ann Sullivan, Alan Smith
Northern Sarup Tayal
North-West Ashish Sukthankar
Oxford Gill Wildman
South East Thames Cindy Sethi
South-West Zoe Warwick
South-West Thames Steven Estreich
Trent Jyoti Dhar
Wessex Neelam Radja, Leela Sanmani
West Midlands Sashi Acharya
Yorkshire Amy Tobin-Mammen
Co-opted Members David Daniels, Nicola Low

The National Audit Group have produced a document: BASHH Regional Audit Chairs - Connecting BASHH National Audits to Local Quality Improvement and Clinician Revalidation, to suport the role of the Regional Audit Chairs. A Word version of Appendix 1 of this document for reporting to the NAG is also available, as well as a template Certificate for annual certification of the work done by BASHH Regional Audit Chairs (for use in appraisals and other evidence of achievement). A template evaluation form for evaluation of Regional Audit Meetings is also available.

NATIONAL AUDIT PROGRAMME:

To help clinics with forward planning with their organizations, to register audits and participate in the BASHH national audits, here is the proposed BASHH audit programme until 2014 :

2011 STI Management Standards (STIMS) Audit

2012 Asymptomatic Screening re-audit

2013 Sexual Health care of HIV patients re-audit

2014 STIMS re-audit, repeating questions from 2011 audit for re-audit purposes, but also possibly introducing further questions against the BASHH Standards

It is intended to launch these audits for data submission on the 1 January of each year, based on clinical practice of the previous three months. The re-audits are important to provide data for performance review and to demonstrate the GMC requirement of completing an audit cycle within 5 years.

AUDIT DATA & REPORTS AVAILABLE ON THE BASHH WEBSITE

(Individual clinic performances are not published on this website- please contact your BASHH Regional Audit Chair for these data.) 

2011 Audit against the Key Performance Indicators in the BASHH MedFASH Standards for the Management of Sexually Transmitted Infections. The national aggregate made up of regional performances is available in the form of pivot tables: 2011 Audit against BASHH MedFASH KPIs-national aggregate made up of regions, as well as a PowerPoint presentation: BASHH 2011 Audit against BASHH MedFASH Standards KPIs. The workbook used by clinics to collect data for the Audit is available: STIMS Audit Workbook1Jan11. An example individual clinic report is available here: Example STIMS clinic report 

2010 Re-Audit of Sexual History Taking. The national aggregate of regional results of the Case Notes part of the Audit is available in the form of pivot tables: BASHH National Re-Audit of Sx Hx Taking 14Oct10, as well as a PowerPoint presentation: NAG 2010 BASHH National Re-Audit of Sx Hx Taking 08Dec10 (This re-audit did not have a separate clinic policies part).

2009 Asymptomatic Screening Audit. The national aggregate of regional results of the Case Notes part of the Audit is available in the form of PivotTables: BASHH 09 Audit Asympto Scr Case Notes National aggregate 27Oct09, as well as a PowerPoint presentation: BASHH 09 Audit Asympto Scr Case Notes 27Oct09, summarising the main findings. The presentation given at the Second Joint Conference of the BHIVA/BASHH in Manchester 20-23 April 2010 is also available: NAG BHIVA BASHH AsymScrAudit 23April10. The national aggregate of regional results of the Clinic Policies part of the Audit is also available in the form of PivotTables: BASHH 09 Asymptomatic Screening Audit ClinicPolicies

2008 Sexual History Taking Audit. The national aggregate of regional results of the Case Notes NAG Sexual History Case Notes Audit 08 spreadsheet and Clinic Policies NAG Sexual History Clinic Policies Audit 08 spreadsheet parts of the 2008 Audit are available, as well as two PowerPoint presentations, one summarising the main findings from the Case Notes and Clinic Policies Audits Sexual History Taking Audit summary findings 09Jan09, and the other providing some more detailed information on the Case Notes Audit findings Sexual History Taking Audit Case Notes Audit detail 21Jan09 detail.

2007 Chlamydia Audit. The national aggregate of regional results of the Case Notes part of the Chlamydia Audit are available on a spreadsheet (this file may take some time to load) along with accompanying notes. A summary of this report is also available as a PowerPoint presentation: Chlamydia Audit.The national results of the Clinic Policies part of the 2007 Chlamydia Audit are also available on a spreadsheet. A table showing regional chlamydia contact tracing performance is also available. The online questionnaires used in the 2007 Chlamydia Audit have now replaced the previous questionnaires on the National Audit Group's audit proforma matrix.

2006 Sexual Health of PWHIV. The results of the 2006 National audit are available as a report entitled National audit of sexual healthcare of people with HIV 2006. This report is also summarised as PowerPoint presentation: PWHIV Audit . The results of the clinic policy section of the 2006 National audit of sexual healthcare of people living with HIV are available here.

2004 National Audit on Early Syphilis- Case Notes Report 2004.

ACTIVITIES

2011. An oral presentation of the results of the 2011 Audit against the Key Perfomance Indicators in the BASHH & MedFASH STI Management Standards was presented at the BASHH Spring Conference on 11 May 2011 in Newcastle. The NAG is working with the BASHH Clincal Standards Unit to help further define the Standards' KPIs for quality measurement. The BASHH and Medical Foundation for AIDS and Sexual Health proposal to the Healthcare Quality Improvement Partnership for a new national audit topic on sexually transmitted infections has been accepted; this was with the support of many other key stakeholders involved in Sexual Health and HIV infection management. The NAG also contributed to audit tools for NICE Public Health Guidance: Increasing the uptake of HIV testing.

2010. The Re-audit of Sexual History Taking, based on key questions from the 2008 baseline Audit, was completed- see above: REPORTS AVAILABLE ON THE BASHH WEBSITE. An oral presentation on the Asymptomatic Screening Audit was given during the Second Joint Conference of the BHIVA/BASHH in Manchester 20-23 April 2010. Funding from the Department of Health was obtained for an audit against the BASHH Standards for the Management of STIs, planned for launch in January 2011.

2009. The 2009 National Audit on Asymptomatic Screening in UK GUM clinics is completed- see above: REPORTS AVAILABLE ON THE BASHH WEBSITE. An oral presentation on the Asymptomatic Screening Audit was given during the Second Joint Conference of the BHIVA/BASHH in Manchester 20-23 April 2010. The National Audit Group provided a presentation on connecting BASHH national audits to local audit and practitioner re-certification at the 2009 ISSTDR/BASHH Conference: NAG presn on Audit Revalidation at ISSTDR BASHH09.

2008. The 2008 National Audit Sexual History Taking Audit is completed- see above: REPORTS AVAILABLE ON THE BASHH WEBSITE. A copy of the poster presentation of this Audit is available: NAG National Audit of Sexual History poster ISSTDR BASHH09. The reports on the national aggregate results are published in the International Journal STDs & AIDS (see below under Publications).

2007. The first web-based audit, funded by the BASHH, and the largest audit to date, was on the management of chlamydial infection in sexual health clinics. The regional aggregates of clinic results of the Chlamydia audit have been sent to the Regional Audit Chairs, and the reports on the national aggregate results are published in the International Journal STDs & AIDS (see below under Publications). Dr Sumit Bhaduri presented a poster on the case notes part of the Audit at the BASHH Spring meeting in New York. Hilary Curtis provided the on-line system of data collection and reporting.

2006. The 2006 audit was on the Sexual Healthcare of People with HIV infection. Results have been disseminated via Regional Audit Chairs to participating centres. Dr Chris Carne presented the results to the BASHH OGM in March. Dr Hugo McClean presented a poster at the BASHH Spring meeting in Blackpool. Two reports on the national aggregate results have been published in the International Journal STDs & AIDS (see below under Publications).

2005. The 2005 audit was a collaborative exercise with the Health Protection Agency. This audited the offering of HIV antibody testing to men who have sex with men. This was presented as a poster at the EADV meeting (see below under Conference Presentations). 97% of MSM in England were offered a test as new patients. 84% of these accepted the offer. Clinics were less good at offering tests to re-attenders: this finding should be addressed in Regional Audit Groups. Regional chairs received local data for discussion on measures to improve uptake of testing in this group. This Audit is reported in Sexually Transmitted Infections (see below under Publications).

2004. The annual audit in 2004 was on the management of early syphilis. Data were collected on an electronic database, which allowed comparisons of inter- and intra- regional variation in performance. Regional data were circulated to regional audit chairs for local presentation and action to improve outcomes. The national aggregate results were reported in three papers, the International Journal STDs & AIDS (see below under Publications). Particular areas for concern were variation in treatment regimes and outcome of contact tracing in early syphilis.

The first national audit by the non- consultant career grade group used an adapted version of the chlamydia audit proforma, in a highly successful audit published in the International Journal STDs & AIDS in 2005(see below under Publications).

2003. The Group conducted its first National Audit in 2003 on the management of gonorrhoea. This was published in the International Journal STDs & AIDS in 2006 (see below under Publications), and showed broad adherence to the National Guideline, and achievement of the outcome standards.

REGISTER OF REGIONAL AUDITS

A valuable resource of regional audit summaries for sharing with members in other regions can be accessed here (Members page). Please click here to download the NAG Regional Audit Report Proforma on which a summary of regional audit results can be emailed to hugo.mcclean@chcphull.nhs.uk, for posting on the Members page.

PUBLICATIONS OF BASHH NATIONAL AUDIT REPORTS

  • Carne CA, McClean H, Sullivan AK, Menon-Johansson A, Gokhale R, Sethi G, Mammen-Tobin AG, Daniels D on behalf of the National Audit Group of the British Association for Sexual Health and HIV. National audit of asymptomatic screening in UK genitourinary medicine clinics: clinic policies audit. Int J STD AIDS, July 2010 21:512-5.
  • McClean H, Carne CA, Sullivan AK, Menon-Johansson A, Gokhale R, Sethi G, Mammen-Tobin AG, Daniels D on behalf of the National Audit Group of the British Association for Sexual Health and HIV. National audit of asymptomatic screening in UK genitourinary medicine clinics: case-notes audit. Int J STD AIDS, July 2010; 21:506-11.
  • C Carne, H McClean, S Bhaduri, R Gokhale, G Sethi, D Daniels on behalf of the National Audit Group of the British Association for Sexual Health and HIV. UK National Audit of Sexual History-taking: Case-notes audit. Int J STD AIDS, May 2009; 20: 351 - 354.
  • H McClean, C Carne, S Bhaduri, R Gokhale, G Sethi, D Daniels on behalf of the National Audit Group of the British Association for Sexual Health and HIV. UK National Audit of Sexual History-taking: Clinic policies audit. Int J STD AIDS, May 2009; 20: 355 - 357
  • Carne C, McClean H, Bhaduri S, Bunting P, Fernandes A, Dhar J, Estreich S, Daniels D. UK National Audit of chlamydial infection management in sexual health clinics. Clinic policies audit. Int J STD AIDS. 2008 Jul;19(7):477-9
  • H L Munro, C M Lowndes, D G Daniels, A K Sullivan, A J Robinson. National study of HIV testing in men who have sex with men attending genitourinary clinics in the United Kingdom. Sex Transm Infect 2008;84:265-270
  • McClean H, Carne C, Bhaduri S, Bunting P, Fernandes A, Dhar J, Estreich S, Daniels D. UK National Audit of chlamydial infection management in sexual health clinics. Case notes audit: information-giving, partner notification and follow-up. Int J STD AIDS. 2008 Jul;19(7):473-6
  • McClean H, Carne C, Bhaduri S, Bunting P, Fernandes A, Dhar J, Estreich S, Daniels D. UK National Audit of chlamydial infection management in sexual health clinics. Case notes audit: demography, diagnosis and treatment. Int J STD AIDS. 2008 Jul;19(7):469-72
  • McClean H, Carne C, Bunting P, Wilkins E, Tucker L, Baguley S, Daniels D, on behalf of the National Audit Group of the British Association for Sexual Health and HIV. UK national audit of sexual health care for people with HIV infection: clinic policies. Int J STD AIDS 2007; 18:635-8
  • Carne C, McClean H, Bunting P, Wilkins E, Tucker L, Baguley S, Daniels D, on behalf of the National Audit Group of the British Association for Sexual Health and HIV. UK national audit of sexual health care for people with HIV infection: case-notes audit. Int J STD AIDS 2007; 18:639-42
  • Price IH, Menon-Johansson A, Daniels D. National Audit Group of the British Association for Sexual Health and HIV. A National Audit of gonorrhoea management. Int J STD AIDS 2006; 17: 133-4
  • McClean H, Daniels D, Carne C, Bunting P, Miller R. National Audit Group of the British Association of Sexual Health and HIV. UK national audit of early syphilis management case-notes audit: contact tracing, information giving, follow-up and outcomes. Int J STD AIDS 2006; 17: 340-3
  • McClean H, Daniels D, Carne C, Bunting P, Miller R. National Audit Group of the British Association of Sexual Health and HIV. UK national audit of early syphilis management case notes audit: diagnosis and treatment. Int J STD AIDS 2006; 17: 334-9
  • McClean H, Daniels D, Carne C, Bunting P, Miller R. National Audit Group of the British Association of Sexual Health and HIV. UK national audit of early syphilis management. Clinics audit: screening for and management of early syphilis. Int J STD AIDS 2006; 17: 344-8
  • Rachel Challenor, Sue Pinsent, Shamala Chandramani, Nick Theobald, and David Daniels. The management of Chlamydia trachomatis in genitourinary medicine clinics: a national audit in 2004. Int J STD AIDS, 1 July 2005; 16: 494 - 504.

CONFERENCE PRESENTATIONS

  • H McClean. Oral presentation BASHH 2011 Audit against the Key Performance Indicators in the BASHH MedFASH Standards for the Management of Sexually Transmitted Infections. BASHH Spring Meeting, Newcastle 11-13 May 2011 
  • H McClean, CA Carne, AK Sullivan, A Menon-Johansson, R Gokhale, G Sethi, AG Mammen-Tobin, D Daniels. National Audit of Asymptomatic Screening in UK Genitourinary Medicine Clinics: Case notes audit. Oral presentation Second Joint Conference of the BHIVA/BASHH in Manchester 20-23 April 2010
  • Christopher Carne, Hugo McClean, Sumit Bhadhuri, Ravindra Gokhale, Cindy Sethi, David Daniels on behalf of the National Audit Group of the British Association for Sexual Health and HIV. BASHH 2008 National Audit of Sexual History Taking in UK Genitourinary Medicine Clinics: Case Notes Audit. Poster ISSTDR/BASSH Spring Meeting. London, 2009
  • Sumit Bhaduri, Hugo McClean, Paul Bunting, Arnold Fernandes, Jyoti Dhar, Steve Estreich, David Daniels. UK National Audit of Chlamydial Infection Management. Poster BASSH Spring Meeting. New York, USA 2008
  • McClean H, Carne C, Bunting P, Wilkins E, Tucker L, Baguley S, Daniels D. UK National Audit of Sexual Healthcare of People with HIV Infection. Poster BASHH Spring Meeting. Blackpool, UK 2007.
  • McClean H. Evidence into Practice- UK National Audit of Early Syphilis Genitourinary Medicine Clinics 2002-03. Case notes Audit. Oral Presentation. BASHH Spring Meeting. Nottingham 2006
  • McClean H, Daniels D, Carne C, Bunting P, Miller R. UK National Audit Of Early Syphilis Management. Poster BHIVA/BASHH Spring Meeting. Dublin 2005
  • Munro H, Lowndes C, Robinson A, Sullivan A, Daniels D. HIV Testing: Offering and uptake of tests among men who have sex with men attending genitourinary clinics in the UK - the national picture. Poster 14 th Congress of the European Association for Dermatovenereology. London 2005

NATIONAL AUDIT GROUP AUDIT QUESTIONNAIRES- these are currently being updated

The Regional Audit Chairs produce a set of questionnaires for conducting audit on sexually transmitted infections and related conditions against the BASHH Clinical Effectivenes Group National Guidelines. These are posted below for use as audit tools.

Comments on these questionnaires may be emailed to christopher.carne@addenbrookes.nhs.uk or hugo.mcclean@chcphull.nhs.uk

Please note that updated questionnaires dealing with infections that require partner notification have not yet been posted, whilst ratification of a dedicated questionnaire on partner notification is awaited. Meanwhile, if you need to see an updated version of any of these questionnaires, please contact: hugo.mcclean@chcphull.nhs.uk   


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TOPIC CLINIC POLICIES AUDIT
CASE NOTES AUDIT
Adolescents Adolescents clinic policies
Adolescents case notes
Asymptomatic screening Asymptomatic Screening Clinic Policy Asymptomatic Screening Case notes
Bacterial vaginosis Bacterial vaginosis clinic policies Bacterial vaginosis case notes
Candidiasis, vulvovaginal Candidiasis clinic policies audit Candidiasis case notes audit
Chancroid Chancroid clinic policies Chancroid case notes
Chlamydial infection
Chlamydial infection clinic policies Chlamydial infection case notes
Chronic pelvic pain syndrome/
Chronic prostatitis
Chronic pelvic pain syndrome clinic policies Chronic pelvic pain syndrome case notes
Epididymo-orchitis Epididymo-orchitis Clinic Policy
Epididymoorchitis Case Notes
Gonorrhoea Gonorrhoea Questionnaire Gonorrhoea Case Notes
Hepatitis (Acute) Acute Hepatitis Clinic Policy
Acute Hepatitis Case Notes
Hepatitis A Vaccine Hep A vacccination clinic policies
Hep A vaccination case notes audit
Hepatitis B Vaccine Hep B vaccination clinic policies
Hep B Vaccine Case Notes
Hepatitis B Chronic Hep B Chronic HIV-neg Clinic Policy
Hep B Chronic HIV-neg Case Notes
Hepatitis C Hep C Clinic Policy
Hep C Case Notes
Herpes simplex virus infection
HSV clinic policies HSV case notes
HIV- Sexual healthcare Sexual Healthcare of people with HIV Infection Clinic Policy
Sexual Healthcare of People with HIV Case Notes
HIV- testing HIV testing clinic policies HIV testing Case notes
Lymphogranuloma venereum LGV clinic policies LGV case notes
Molluscum contagiosum Molluscum contagiosum clinic policies Molluscum contagiosum case notes
Non-specific urethritis NSU Clinic Policy NSU Case Notes
Partner notification Partner notification clinic policies Partner notification case notes
Pelvic Inflammatory Disease PID Clinic Policy

PID Case Notes

Scabies/Pubic Lice Scabies/Lice Clinic Policy
Scabies Case Notes
Pubic Lice Pubic Lice Case Notes
PEPSE PEPSE clinic policies PEPSE case notes
Sexual History Sexual History Clinic Policy

Sexual History Case Notes 2008

Sexual History Re-audit Case Notes 2010

Sexually Acquired
Reactive Arthritis
SARA Clinic Policy
SARA Case Notes
Syphilis Early Syphilis Clinic Policy

Late Syphilis Clinic Policy

Late Syphilis Case Notes

Early Syphilis Case Notes

Trichomoniasis Trichomoniasis clinic policies Trichomoniasis case notes
Warts Anogenital warts clinic policies Anogenital warts case notes

AUDIT GROUP MEETING MINUTES

The National Audit Group usually meets three times each year (January, June and October). BASHH Members can access the NAG Meeting Minutes here.

NATIONAL QUALITY DRIVERS

The Royal College of Physicians (RCP) Clinical Resources webpage provides essential information on clinical audit and quality improvement, including a section on revalidation in practice. The RCP's Clinical Standards Department has also produced the Local clinical audit: handbook for physicians (August 2010) which provides "... all you need to know to do effective, robust and worthwhile clinical audit in your own organisation." The Royal College of Physicians is at an advanced stage in developing an on-line tool (pCAT, the personal Clinical Audit Tool) to facilitate the recording of the audit process, and developing outcomes from audit work. A pilot of pCAT will start soon.

The Healthcare Quality Improvement Partnership promotes the reinvigoration of local and national audit by providing support to integrate clinical audit into national quality agendas. HQIP, working with the Department of Health National Clinical Audit Advisory Group (NCAAG), manages the group of national audits in England, known as NCAPOP, funded by the Department of Health, as well as funding to support the development of multi-site clinical audits within England. The HQIP website contains a wealth of useful information about clinical audit, including a National Clinical Audit Forum.

The Academy of Medical Royal Colleges has produced Clinical Audit and Revalidation. Report and Recommendations. This gives the essential principles that an audit must follow to be acceptable to the GMC for revalidation. These principles are detailed in the table beginning on page 9, including to "reflect on the results of local and non-local clinical audit that relate to the doctor's practice or to the care provided by the doctor's clinical team," and "the taking of appropriate action in response to the results." The table beginning page 14, lists the criteria and indicators of a high quality clinical audit.

The National Institute for Clinical Excellence has produced Quality Standards relating to specific areas of care and prevention. These are used by health and social care professionals, patients, services and commissioners of services to decide whether high quality, cost-effective care is being provided. Completed public health guidance includes Increasing the uptake of HIV testing among Black Africans in England, Increasing the uptake of HIV testing among men who have sex with men and Prevention of sexually transmitted infections and under 18 conceptions.

The Care Quality Commission (CQC) is the health and social care regulator for England. CQC licenses providers of health and social care services if they meet essential standards, and monitors providers to make sure they continue to meet these standards.


This page was last updated on 21 November 2011