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Use of Clinical Audit to Improve Quality Between Providers

21 October 2015

Ensuring strong clinical governance principles are embedded into physiotherapy practice is essential for safe and effective healthcare. As part of our commitment to this, at this year’s Physiotherapy UK conference our very own National Clinical Manager, Aimee Robson, presented a poster under the leading change theme.

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IMG_9260Aimee’s poster, entitled ‘Use of clinical audit to improve quality between providers’, demonstrates the use of clinical audit outcomes to change the process and performance of several hospitals within the North East and was one of four nominated to be part of this year’s ‘how to become a leader’ poster walk. These scientific posters are selected for those who wish to find out more on leadership and leading for change, as they offer valuable insight into the latest ideas, innovations and research occurring within the world of physiotherapy.

For those of you unable to attend Physiotherapy UK, we spoke to Aimee and asked her to outline the main processes and methods behind this project and the results of the clinical audit;


Within the North East of England, 7 Clinical Assessment and Treatment Services (CATS) were commissioned to Connect within the community. Involved in these, we were responsible for delivering services working inter-provider with 9 diagnostic imaging providers in the same region.

Each hospital radiology provider had a different way of working and we found that the process for management of serious diagnoses was different across all providers, res
ulting in inefficiencies.

As part of introducing ways of working between providers I introduced procedures between providers to manage the flow of patients and ways of working, and established these into protocols.



To implement Standard Operating Procedures (SOPs) between organisations in a protocol to cover areas of risk in the interface between a Physiotherapy CATS clinic and radiology departments.

To evaluate the impact of the SOPs on the timely management of Red Dot Procedure or Serious Diagnosis management for patients post diagnostic imaging report.


I contacted the 9 radiology departments, who acknowledged the deficiencies, and persuaded them adopt a standard SOP with a view to assessing impact on the patient pathway for Serious Diagnoses. We also agreed to meet every 3-6 months and discuss key issues as well as flag any serious incidences so that we could investigate them together. Additional information reviewed in this clinical audit revealed that in 2014:

  •  100% of the patients referred from GPs had NO red flags on paper referral.
  • 10 patients had PMH of cancer that can metastasize to bone-absence of MCC coordinator/pathway in region but had no other red flag symptoms.
  • 100% of the diagnostic imaging referrals matched Royal College Radiology (RCR) Guidelines.


  • Introducing SOPs significantly improved quality of the turnaround time of patient’s management of Serious Diagnoses, with a 75% reduction in turnaround time of all providers’ region.
  • Use of Clinical Audit and standard benchmarking to monitor has been highly effective.
  • Physiotherapists have the leadership capability to influence pathway design and improve quality of care.
  • This has resulted in improved and faster healthcare delivery for patients across a large geographic region.

Click here
 to download the poster as a pdf, which provides full details on the audit and contact details for you to speak with Aimee in more detail.

To find out more information on our work in Community Services, click here.

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