Measuring how well the NHS looks after its own staff: methodology of the first national clinical audits of occupational health services in the NHS

Williams, S., Rogers, C.A., Peel, P., Harvey, S.B., Henderson, M., Madan, I., Smedley, J. and Grant, Robert (2012) Measuring how well the NHS looks after its own staff: methodology of the first national clinical audits of occupational health services in the NHS. Journal Of Evaluation In Clinical Practice, 18(2), pp. 283-289. ISSN (print) 1356-1294

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(i) Rationale, aims, objectives Little is known about the quality of occupational health care provided to NHS staff. We designed the first national clinical audits of occupational health care in England. We chose to audit depression and back pain as health care workers have high levels of both conditions compared with other employment sectors. The aim of the audits was to drive up quality of care for staff with these conditions. The object of this paper is to describe how we developed an audit methodology and overcame challenges presented by the organisation and delivery of occupational health care for NHS staff. (ii) Method We designed two retrospective case note audits which ran simultaneously. Sites submitted up to 40 cases for each audit. We used duplicate case entry to test inter-rater reliability and performed selection bias checks. Participants received their site�s audit results, benchmarked against the national average, within four months of the end of the data entry period. We used electronic voting at a results dissemination conference to inform implementation activities. (iii) Results Occupational Health departments providing services to 278 (83%) trusts in England participated in one or both audits. Median Kappa scores were above 0.7 for both pilot and full audits, indicating �good� levels of inter-rater reliability. 79% of participants at a dissemination conference said that they had changed their clinical practice either during data collection (52%) or following receipt of their audit results (27%). (iv) Conclusions Clinical audit can be conducted successfully in the occupational health setting. We obtained meaningful data that has stimulated local and national quality improvement activities. Our methodology would be transferable to occupational health settings outside the NHS and in other countries.

Item Type: Article
Additional Information: The definitive version is available at
Research Area: Primary care and other community based clinical subjects
Other hospital based clinical subjects
Health services research
Faculty, School or Research Centre: Faculty of Health and Social Care Sciences (until 2013)
Related URLs:
Depositing User: Robert Grant
Date Deposited: 26 Nov 2010 12:18
Last Modified: 07 Jan 2013 11:01

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