The hidden cost of clinical audit: a questionnaire study of NHS staff

Objectives: To determine the full cost of clinical audit in one health boar d area and extrapolate the result to Scotland. Methods: A questionnaire was sent to a representative sample of NHS staff to determine lime spent on cl inical audit. This was combined with cost data from clinical audit budgets and unit cost data for staff time. Results: Seventy-two percent of staff pa rticipated in clinical audit at some point in time. Medical staff were sign ificantly more likely to participate in audit that non medical staff (P < 0 .0001). Those who participated in clinical audit devoted only a small propo rtion of time to it. However, due to the high participation rates in clinic al audit. this aggregated to a significant amount. In Forth Valley the tota l cost was estimated to be pound 1.72m (pound 1.37m-pound 2.10m) and in Sco tland pound 36.3m (pound 29.6m-pound 44.0m). Staff time accounted for over 80% of the total cost of clinical audit. Conclusion: Clinical audit is wide spread within the Scottish NHS and the total cost of staff time devoted to audit is substantial. Research is needed into the value of clinical audit a nd the potential cost implications of clinical governance need to be explic itly recognised. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved .