Clinical audit

Clinical audit

Community pharmacy contractors must undertake a clinical audit each year, the topic of which they choose. In addition to this pharmacy-based audit, they must also complete an audit on a topic that has been determined by NHS England and NHS Improvement (NHSE&I).

NHS England and NHS Improvement determined audits

Since the introduction of the Community Pharmacy Contractual Framework in 2005, community pharmacies have been required to carry out an annual audit where the topic of the audit was determined locally by the Primary Care Trust or latterly by the local NHS England team. It was agreed that in 2014/15, rather than audit topics being chosen by local NHSE&I teams, one nationally agreed audit would be undertaken by all pharmacies.

2021/22 National pharmacy clinical audit

PSNC and NHSE&I have agreed that the 2021/22 national clinical audit will focus on valproate, with the aim of reducing the potential harm caused by taking valproate during pregnancy. The audit must be completed by all community pharmacy contractors as this is part of their NHS contractual requirements.

Contractors who participated in the 2019/20 Pharmacy Quality Scheme (PQS) may have completed a similar valproate audit as this was a quality criterion within this Scheme. The 2021/22 national clinical audit will be based on the PQS audit and will allow contractors to close the audit cycle by re-auditing their practice.

NHSE&I recently shared the results of the PQS 2019/20 valproate audit in a presentation at the Pharmacy Show. Of the 12,068 girls or women of childbearing potential (or their representative, where appropriate) who agreed to participate in the audit:

  •  675 (5.6%) said that they had not been provided with advice and information in line with the MHRA Drug Safety Update 2018 concerning the potential impact on an unborn child;
  • 10.6% did not have a copy of the Patient Guide;
  • 11.1% did not have a copy of the Patient Alert Card; and
  • 4,374 (36.2%) women advised they did not have highly effective contraception in line with the Pregnancy Prevention Programme and of these 1,159 (26.5%) were referred/signposted back to their GP or specialist to discuss contraception.

The results therefore show that while a high number of patients were aware of the safety considerations, there is still more work to be done to ensure women and girls receive the correct information about valproate and the risk of birth defects.

The paperwork for the audit is being finalised and further information on the audit time period and how the audit results are to be submitted will be confirmed shortly; PSNC will alert contractors through our normal communication channels when this is available.

Previous nationally determined audits

The 2018/19 CPCF national clinical audit on flu vaccination for people with diabetes

The 2014/15 CPCF national clinical audit on emergency supply

Pharmacy chosen audit

The annual clinical audit, the topic of which is chosen by the pharmacy, can focus on an appropriate topic of relevance to the practice of the individual pharmacy team. Guidance on undertaking clinical audits can be found via the link below, alongside template audits developed for use by pharmacy teams.

It is not a requirement in the terms of service to send your pharmacy chosen clinical audit results to NHSE&I. However, pharmacy contractors should be prepared to demonstrate they have carried out a clinical audit at the time of any contract monitoring visit carried out by NHSE&I.

A guide to clinical audit

Valproate medicines safety (Company Chemists’ Association)

PSNC audit on LABA as monotherapy for the treatment of asthma without ICS preventer treatment

Hydration messages to prevent acute kidney injury clinical audit (on PharmOutcomes)

NSAID clinical audit (on PharmOutcomes)

RPS audit hub, including templates

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