Shared learning database

Berkshire Healthcare NHS Foundation Trust
Published date:
February 2011

E-tools can help encourage the auditing of NICE guidance and enable the easy review of compliance levels across the Trust.

Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?


Aims and objectives

To increase the evidence for compliance with NICE guidance across this mental health Trust. 1. To increase the auditing of NICE guidance, thereby revealing levels of compliance across the Trust and highlighting where improvements are required. 2. to make the results of NICE audits easily available to both clinical audit department staff and to the NICE review committee 3. to easily identify to both audit department staff and the NICE review committee to what extent the Trust is complying with guidance, in order to take action themselves or to feed up to the CEEC (and then the Board).

Reasons for implementing your project

1. A review took place of Trust NICE guidance implementation by a newly recruited Clinical Audit Manager. A lack of auditing of NICE guidance was revealed. At the same time there was awareness that doctors, especially juniors could choose NICE guidance for the audit that they are required to complete whilst on their 6 month rotation. Doctors therefore needed to be encouraged to audit the guidance. These trainee doctors also needed tools which would make the audit process simpler for them. 2. There was also a lack of a quick and easy way in which to bring together the reports from audits of NICE guidance and to highlight the outcomes.

How did you implement the project

1. A member of the clinical audit department was asked to devise audit e-tools for NICE guidance that was relevant to the Trust. Costs were incurred for the time it took for this person to devise the tools (this was fairly minimal as an IT competent member of staff was the person chosen to complete this task). The format of the existing tools from the audit support literature, found on the NICE website was referred to. The general style of the tool was used and placed on the clinical audit department's intranet page. 2. A spreadsheet containing all NICE guidance that was relevant to the Trust already existed. This was managed by the Chair of the NICE Review Committee (who was a senior manager and was highly committed to ensuring that NICE guidance was correctly managed across the Trust). Discussion between the Clinical Audit Department and the Chair of the NICE Review Committee identified that this spreadsheet could be extended to include columns to contain hyperlinks to reports and presentations from NICE audits (thereby containing easily obtained evidence for compliance levels). The idea of colour coding was to act as a quick visual reference.

Key findings

1. E-tools which would make auditing easier (and which trainee doctors will appreciate as they have limited time within the Trust). This increase in speed and simplicity was intended to increase the amount of guidance being audited. As these e-tools have been available on the Trust intranet for less than a year, it is still too early to see any huge improvement in the auditing of NICE guidance. However, we are keeping a close eye on the numbers and will continue to look for ways to increase the extent of auditing. 2. Reports from the above audits are now kept together in one electronic folder and attached by hyperlink to a spreadsheet of all NICE guidance which is relevant to this mental health Trust. Colour codes have been used to identify levels of compliance. This evidence is stored on a shared electronic file so that it can be updated by both the clinical audit department and the Chair of the NICE Review Committee. The Chair can take this information to the NICE Review Committee meetings, in order to discuss the need for any actions. Where appropriate this information is fed up to the Clinical Excellence and Effectiveness Committee (ensuring that senior managers are kept informed).

Key learning points

Publicise the existence of the audit e-tools across the Trust: at a recent presentation (made in order to promote the service provided by the clinical audit department), the e-tools were demonstrated to CAMHS consultants. These tools were greeted with delight though it became clear that until then to some, their existence had been unknown. As a result, the clinical audit department has decided to increase the amount of publicity given to the audit department and the resources that are available to help staff carry out audits of NICE guidance. This publicity will include similar presentations to other specialties, a mention at committee meetings, plus inclusion in the monthly Trust-wide Audit Newsletter and use of specialty notice boards. Involve staff that are IT literate: In terms of setting up the audit e-tools, we involved staff that were familiar with the IT, so it was relatively simple task.

Contact details

Claire Newton
Clinical Effectiveness Facilitator
Berkshire Healthcare NHS Foundation Trust

Secondary care
Is the example industry-sponsored in any way?