Letters p 1905

Every year in the United Kingdom, millions of pounds are spent on clinical audit, and the results are arguably disappointing. “Action on clinical audit” is a two year project, funded by the NHS Executive, with the aim of shedding light on why clinical audit does not achieve the sort of changes and improvements in patient care that the audit cycle is expected to produce. Last September, 10 self selected hospital trusts signed up to the project.1The arrival of the NHS white paper, with its call for clinical governance (trusts must now make strategic decisions based on clinical evidence and not simply on economic considerations), raises the profile of the action on clinical audit project even higher, and a second cohort of 12 trusts plans to join the project in late 1998. Each participating trust has identified a clinician, a manager, and an audit officer, who together make up a local action team. The mission of each team is to identify local issues that could be barriers to audit working well in its own trust, and to devise projects to address these obstacles.

Last month, I visited West Middlesex University Hospital NHS Trust to find out what it is up to, and how far it feels progress is being made.