The development of multiprofessional audit and clinical guidelines: their contribution to quality assurance and effectiveness in the NHS

Abstract

In an attempt to improve the cost-effectiveness of the NHS, the responsibility for the provision and purchasing of health care services has been separated by the creation of a managed market. Quality assurance mechanisms have been introduced to reassure professionals and the public that quality will be maintained as costs are controlled. Providers of health care have adopted a number of approaches to improving quality, mainly derived from industrial models. Over the last 10 years these have progressed from involving managerial processes only, through uniprofessional medical and nursing audit to multiprofessional clinical audit. Commissioners of care are seeking to utilise audit within contracts to ensure that only services that have been proven to be effective are purchased. The government has introduced a number of national policies to facilitate this approach; including a research and development strategy, supporting continuing professional development and restructuring the complaints procedures. Clinical guidelines are seen as a way of combining these initiatives. With further expansion of the market philosophy, through primary care led purchasing and the private finance initiative, all professionals will need to collaborate to ensure that quality services are maintained.

Key Words:

• multidisciplinary clinical audit and clinical guidelines
• clinical effectiveness
• qualityassurance