2 April 2025
What is an audit in healthcare?
Clinical audits are an essential process designed to monitor and improve patient care. Without regular local and national audits of patient care and outcomes, healthcare facilities could be at risk of failing to meet legal standards.
But what exactly is a clinical audit, and how is the clinical audit process carried out? In this guide, we'll cover everything you need to know about the different types of healthcare audits, why auditing in healthcare is important, and how your organisation can conduct effective audits.
what is a healthcare audit
A healthcare audit is a systematic review of clinical practice, patient care, and operational procedures against a defined set of established standards. Through this review, areas that aren't up to standard can be identified and assigned a plan for improvement.
For example, in a healthcare setting, staffing levels, the provision of specialised equipment, waiting times, adherence to protocols, mortality rates, and hygiene practices would all need to be assessed to determine whether the facility meets relevant care standards. Even elements like the condition of healthcare uniforms would need to be evaluated, as poorly maintained or non-compliant PPE and workwear could present a severe infection and cross-contamination risk in healthcare settings.
Ultimately, by identifying and helping to improve sub-standard processes, healthcare audits can improve patient outcomes and help to standardise high-quality care across healthcare facilities.
Healthcare audits can be undertaken at a national or local level. In a national healthcare audit, facilities can be assessed across the entirety of the NHS or private healthcare organisations. In a local audit, particular trusts, GP services, hospitals, or even specific departments within a healthcare facility can be examined against established care standards or guidelines.
what is a clinical audit?
Clinical audits tend to be the main type of audit that people refer to when they discuss "healthcare audits", as they focus specifically on clinical practices and patient outcomes. So, what is a clinical audit exactly?
As defined by the National Institute for Health and Care Excellence (NICE) in 2002:
“A clinical audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Aspects of the structure, processes, and outcomes of care are selected and systematically evaluated against explicit criteria. Where indicated, changes are implemented at an individual, team, or service level and further monitoring is used to confirm improvement in healthcare delivery.”
In short, a clinical audit measures what is happening in a healthcare setting against what should be happening, then drives improvements where gaps are found.
the clinical audit cycle
The clinical audit process features multiple stages to ensure that best practices are followed, and the best possible outcomes can be achieved. These stages form what is known as the clinical audit cycle, a continuous loop of measurement, evaluation, and improvement.
The four stages of the clinical audit cycle are:
determining best practices/standards/guidelines
An established set of best practices will need to be agreed upon at the start of the clinical audit process to measure current processes against. These will form the audit criteria, the benchmarks against which performance is assessed.
collecting data on existing processes
All relevant data across the organisation or facility will need to be collected and documented to allow for proper analysis. This may include patient records, staff rosters, incident reports, and operational data—depending on the scope of the audit.
comparing data and established standards to identify areas for improvement
Once data is compared with relevant healthcare standards or guidelines, areas of excellence or concern can be identified. Areas that fall short of expected standards should be assigned a clear plan for improvement, with specific actions, owners, and timelines.
implementing change and monitoring ongoing improvements
Action plans should be implemented for any areas that require improvement, and ongoing monitoring will be required to assess the efficacy of these changes. The clinical audit cycle can only be considered complete when data shows that an action plan has resulted in the sustained improvement of an area of concern.
Because the clinical audit cycle is continuous, the process typically begins again once improvements have been embedded. This ensures standards are maintained over time.
other types of healthcare audit
organisational audit
As the name suggests, an organisational audit examines how well an organisation is set up and how well it runs on a day-to-day basis. Since this type of audit examines an entire organisation, it must be external, independent, and measured against a set of defined standards to be effective.
financial audit
Financial audits involve the examination of a healthcare organisation’s financial accounts and transactions. They will be evaluated against legal guidelines to ensure compliance and accurate financial reporting.
internal audit
Internal audits monitor non-clinical processes to ensure they also meet minimum standards. For example, patient complaint processes, administrative processes, and governance can be evaluated to ensure efficiency and effectiveness across the board.
other review processes
There are various other healthcare review processes that are audit-adjacent or can form part of a healthcare audit. For example, peer reviews may be conducted as part of a clinical audit or separately. They involve a group of clinicians assessing a sample of patients to determine whether the best possible care was provided or whether care processes could have been more effective.
Similarly, routine monitoring of patient outcomes should be conducted on an ongoing basis and not just as part of a clinical audit. More informal patient and staff surveys can also be implemented outside of healthcare audits to gather opinions on the standard of care. Surveys should only be used as part of an official audit if relevant data cannot be collected from another source.
why are audits important in healthcare?
Healthcare audits—including clinical audits, financial audits, organisational audits, and other evaluative processes—are necessary for identifying areas where standards aren't being met and, ultimately, for improving patient outcomes. Here are just some of the key benefits of auditing in healthcare:
1. compliance
Not only is complying with established standards best practice, but it may also be a legal requirement in some cases. By evaluating compliance with these standards through regular healthcare audits, organisations can stay out of legal trouble and adhere to important regulatory requirements.
2. improved patient care
Many of the established standards in healthcare are designed specifically to ensure a certain level of patient care. A thorough clinical audit that measures care procedures against these standards will help to ensure that the quality of care is up to scratch.
3. better outcomes
It goes without saying that improved patient care can lead to better outcomes. If the quality of care is improved because of action plans put in place after a clinical audit, this may increase survival and recovery rates—or at least lead to improved patient confidence and comfort.
4. improved efficiency
In addition to identifying issues with current care procedures, healthcare audits can also reveal inefficiencies in clinical and administrative processes. These inefficiencies can then be addressed to streamline operations and improve resource utilisation. This is a particularly important consideration for large organisations managing complex clinical environments.
5. accountability
After a healthcare audit, a written report will be published for transparency and accountability. Organisations that fail to provide adequate care can then be held accountable—which will encourage them to improve.
how alsico supports healthcare audit readiness
To get the best possible results in your organisation’s next healthcare audit, you need to ensure that all elements of staff conduct and patient care are meticulously examined and optimised – including the uniforms you provide for your workers. By choosing comfortable, flexible, durable, and easily washable healthcare workwear from alsico, you can help your staff perform at their best at all times.
From nurse tunics to healthcare trousers and GP blouses, we supply everything you need to ensure your workforce can deliver optimal outcomes, and you can even order bespoke healthcare uniforms that fit your organisation’s branding. Browse our healthcare clothing catalogue to discover our permanent workwear collections, or get in touch to find out more about our bespoke design and embroidery services.
frequently asked questions
In most healthcare organisations, clinical audits are overseen by a dedicated clinical governance or quality improvement team. However, the audit itself can be led by any qualified healthcare professional. This includes anyone from consultants and senior nurses to junior doctors undertaking audits as part of their training. In larger organisations such as NHS trusts, a clinical audit department will typically coordinate the process, ensuring audits are registered, methodologically sound, and aligned with organisational priorities. Ultimately, accountability for acting on audit findings sits with the relevant clinical or departmental lead.
There is no single mandated frequency for clinical audits. It depends on the type of audit and the organisation. National clinical audits, such as those commissioned by NHS England or NICE, follow set annual or rolling schedules. Local audits are determined by the trust or organisation and may be triggered by a specific concern, a change in guidelines, or as part of a routine governance cycle. What matters most is that re-audits are carried out after changes have been implemented to confirm that improvements have been sustained. This is what closes the clinical audit cycle.
This is a common question, and the distinction is important. A clinical audit measures current practice against established standards to identify where improvements are needed. Research, on the other hand, aims to generate new knowledge. For example, testing whether a new treatment is more effective than an existing one. NICE draws a clear line between the two: audits ask, "are we doing what we should be doing?", while research asks, "what should we be doing?". Clinical audits do not typically require ethics committee approval, whereas research involving patients usually does.
When a clinical audit reveals that standards are not being met, the first step is to develop a clear action plan with specific improvements, assigned owners, and realistic timelines. In most cases, this is managed internally by the relevant department or clinical governance team. A re-audit is then scheduled to assess whether the changes have had the desired effect. In more serious cases (for example, where patient safety is at immediate risk) findings may be escalated to senior leadership, the trust board, or external regulators such as the Care Quality Commission (CQC). For large organisations, having a robust escalation framework in place before an audit begins is essential.
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