A SURVEY OF AUDIT ACTIVITY IN GENERAL-PRACTICE

Background. Since 1991, all general practices have been encouraged to undertake clinical audit. Audit groups report that participation is hi gh, and some local surveys have been undertaken, but no detailed natio nal survey has been reported. Aim. To determine audit activities in ge neral practices and the perceptions of general practitioners (GPs) reg arding the future of clinical audit in primary care. Method. A questio nnaire on audit activities was sent to 707 practices from 18 medical a udit advisory group areas. The audit groups had been ranked by annual funding from 1992 to 1995. Six groups were selected at random from the top, middle, and lowest thirds of this rank order. Results. A total o f 428 (60.5%) usable responses were received. Overall, 346 (85%) respo nders reported 1257 audits from the previous year with a median of thr ee audits per practice. There was no correlation between the number of audits reported and the funding per GP for the medical audit advisory group. Of 997 audits described in detail, changes were reported as 'n ot needed' in 220 (22%),'not made' in 142 (14%), 'made' in 439 (44%), and 'made and remeasured' in 196 (20%). Thus, 635 (64%) audits were re ported to have led to changes. Some 853 (81%) of the topics identified were on clinical care. Responders made 242 (42%) positive comments on the future of clinical audit in primary care, and 152 (26%) negative views were recorded. Conclusion. The level of audit activity in genera l practice is reasonably high, and most of the audits result in change . The number of audits per practice seems to be independent of the lev el of funding that the medical audit advisory group has received. Alth ough there is room for improvement in the levels of effective audit ac tivity in general practice, continued support by the professionally le d audit groups could enable all practices to undertake effective audit that leads to improvement in patient care.