Improving, and auditing, access to clinical trial resultsBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g213 (Published 15 January 2014) Cite this as: BMJ 2014;348:g213
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I think there are two ways that we might improve the contribution that clinical audit can make to stimulating improvement in the quality of care. One is to re-establish a central repository of information on the 50-60 national clinical audits in England. A previous attempt (Directory of Clinical Databases) provided not only information on the data available but also an independent assessment of the quality of the data in the national clinical audit.  Unfortunately after a few successful years the NHS Information Centre decided not to maintain it though it can still be found archived on the web.  There is a current initiative, funded by NHS England and led by the Healthcare Quality Improvement Partnership, to create a new resource during 2014.
The second approach needed is along the lines suggested by Michael Smith. I agree that there are lots of imaginative and enterprising examples of local quality improvement initiatives out there. A website that highlighted the best and most successful ones would help their dissemination and wider uptake. However, it would be essential to ensure that such a resource was kept up to date, often a challenge after the initial enthusiasm starts to wane.
1. Black N, Payne M. Directory of Clinical Databases: improving and promoting their use. Quality and Safety in Health Care 2003;12:348-352
Competing interests: I chair the Nationaal Advisory Group for Clinical Audit & Enquiries that advises NHS England
In Dr Goldacre’s call to action regarding access to clinical trial results he alluded to “the most basic research tool in medicine – audit”. Every year, thousands of audits are done across the NHS by clinicians of all levels, often providing valuable insight into clinical practice and how it can be improved. Yet despite their usefulness, their results are generally confined to the local department they are performed in, or the archives of specialist journals.
With the intention of transparency and spreading the findings from the good work done in audits every year, it seems logical that alongside a clinical trials results database, there should be a national clinical audit results database.
The advantages of such a system would be numerous. They would share clinical improvement strategies (and the evidence that prompted them); facilitate planning of future audits; and provide another transparent indicator of clinical care quality.
NHS England would seem the ideal organisation to take the lead on a national clinical audit results database.
Competing interests: No competing interests