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Richard Steyn

The Case for Clinical Audit in Modern Surgical Practice

Richard Steyn

Multiple high-profile individual and institutional cases (e.g. Paterson, Mid Staffordshire) have hugely impacted public and professional perception of the quality of care provided in the NHS and independent sectors. These concerns about the quality of care have attracted national publicity, public inquiries and a focus on failure. Whilst we must do everything we can to avoid such future failings, these isolated cases should not dominate our thinking about quality of care. Equally we can no longer think about effectiveness of care as an isolated professional matter as we strive to re-establish public and regulatory confidence and trust.

The Care Quality Commission (CQC) recognises clinical audit as an essential component in clinical governance and the delivery of high-quality clinical care and as a professionally led exercise. Effective clinical audit will help maintain standards, identify/highlight problems, support change and ensure that policies have been developed and implemented appropriately. Good clinical audit also facilitates providing evidence of quality of care to regulatory bodies. However clinical audit is perceived negatively at times in that it can be time-consuming, or variable quality, impact on finances, result in change and be perceived as threatening by staff.
This presentation will explore how these different aspects have interplayed in modern surgical practice.


Richard Steyn is a Consultant Thoracic Surgeon and Deputy Medical Director at the University Hospitals Birmingham NHS Foundation Trust and Honorary Associate Professor with the University of Warwick. He is also an active pre-hospital doctor and Strategic Medical Advisor with West Midlands Ambulance Service (WMAS). He has previously been Clinical Director for Thoracic Surgery & Respiratory Medicine, Associate Medical Director – Surgery and Divisional Director for Surgery.

From the early days of the Cancer Services Collaborative, through the period of the NHS Modernisation Agency and subsequently NHS improvement, he has been heavily involved in healthcare design, service improvement and ensuring safe quality healthcare services. Both as Deputy Medical Director and as WMAS strategic medical advisor, he has a major involvement in standards and governance.