The Pharmaceutical Journal
Vol 270 No 7244 p519
12 April 2003

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Excellent guide for those involved in developing audit culture

'Principles for best practice in clinical audit', by the National Institute for Clinical Excellence. Pp x+196.Price £29.95. Oxford: Radcliffe Medical Press; 2002. ISBN 1 85775 976 1

This publication, launched jointly by the National Institute for Clinical Excellence and the Commission for Health Improvement and funded by NICE, aims to support health care staff in strengthening clinical audit within the National Health Service. The impetus for its compilation is Government's clear focus on clinical audit in the wake of the Kennedy report, and the ramifications of that inquiry into children's heart surgery in Bristol resonate in the foreword by Dame Deirdre Hine and Sir Michael Rawlins. To paraphrase, the time has come indeed for everyone in the NHS to take clinical audit seriously.

To what extent does this book meet the challenge? The text provides statements of principle about clinical audit that could guide both the organisation and the individual — in particular, those striving to ensure that audit uses appropriate methods and takes place in a climate where there is a willingness to respond to its findings. A strength of the book is that it makes no assumptions, definitions are provided (including clinical audit itself) and every chapter commences with key points from a review of the literature. For the hard-pressed reader, important terms are defined in the glossary. Each chapter addresses a stage in the clinical audit process, from preparing for audit through to sustaining improvement, and is extensively referenced. In addition, 11 appendices give additional reference material to support local audit programmes and this comprehensive package is rounded off by the inclusion of a CD-ROM containing all the resources associated with the book.

This is an excellent book for those charged with developing the audit culture and for those who educate others on the principles of clinical audit. The text is accessible and written in a manner not to alienate the novice, but the balance of chapters (few) to appendices (many) distinguishes the content from that found in a user manual. However, any hint of criticism based on the latter point would be unjustified, particularly as a recognised handbook of clinical audit already exists. Overall, 'Principles for best practice in clinical audit' is a welcome and valuable guide to placing audit at the centre of clinical governance.

David Webb