Patient involvement in clinical audit at a primary care trust

Abstract

This impact evaluation has been conducted to establish the effectiveness of involving patients in clinical audit and service improvement. Due to the national reconfiguration of primary care trusts (PCTs) where PCTs have been dramatically reduced, some trusts need to secure current structures and processes within the new PCT. Therefore a review of patient involvement in clinical audit and service improvement was carried out in order to continue this partnership work in the new PCT arrangements. In June 2003 a Commission for Health Improvement clinical governance review in Sheffield South West Primary Care Trust was conducted, highlighting patients' lack of involvement in developing and improving services within primary care. Based on these findings, the PCT proposed to create and train a panel of patients and carers to be actively involved in clinical audit and service improvement projects. In April 2004, a clinical audit patient panel (CAPP) was introduced, and an impact evaluation was carried out to establish the level of CAPP individual members' influence on a healthcare organisation, identifying patient involvement and partnership working.It would appear that the CAPP is managed in a structured process that ensures that it is supported, recognised and provided with robust training and information. The CAPP has demonstrated compliance with key national directives including the NHS Plan (2000), Section 11 of the Health and Social Care Act (2001) and the Kennedy Report (2001). Through effective communication and board recognition, the CAPP is a panel of patients who are encouraged and supported to be 'on the inside' of an organisation, able to assist the trust in developing and improving services within primary care. CAPP members have demonstrated this by implementing their knowledge and skills of quality improvement, clinical audit and most importantly by being a patient, carer or member of the public. The panel does not currently include a PCT member of staff. Challenges faced by the panel were around the change in culture towards actively involving patients and carers. Healthcare professionals and the public working together sharing information that is confidential and liable to cause concern at some time, for many, will result in a shift of culture. The CAPP has demonstrated that if recognised and managed effectively, patients and healthcare staff can succeed in effective partnership working.