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Quality Improvement Activity

For the purposes of revalidation you are required to demonstrate that you regularly participate in activities that evaluate the quality and improvement of your work.  

The RCGP consider significant event review and clinical audit as being core elements to quality improvement but are happy to accept other appropriate quality improvement activities that you can demonstrate have had a positive impact on your care of patients.

In the past GPs were told that once in every 5 years they would need to complete a full clinical audit.  This is now not a requirement as defined by the GMC.

Each year at your appraisal you will need to demonstrate that you have been involved in quality improvement activities.

The LMC’s advice is to undertake a variety of quality improvement activities and ensure that, over the five year cycle, some of these enable you to provide evidence that demonstrates the impact and change this activity has had on your clinical practice.

Practice based audits are acceptable so long as you reflect on the outcomes personally, and this impacts your clinical practice and you detail your role in the audit.

QoF is a simple way to audit quality but simply recording and comparing 2 year's results is not acceptable; you need to discuss the outcomes in one year, suggest and implement change and evaluate the impact at a later date.

Quality improvement activities should be robust, systematic and relevant to your work. They should include an element of evaluation and action, and where possible, demonstrate an outcome or change.


At each appraisal you need to demonstrate that you are engaged in quality improvement activities and provide supporting information for this. Examples include:-

There are many examples of audits currently undertaken in most practices including:

It may be more difficult for locums or OOHs GPs to participate in audit, but you could audit your referrals, or look at the next 50 prescriptions for antibiotics, look at avoiding those that can cause clostridia (Co-amoxiclav, ciprofloxacin, cephlosporines and clindamycin). See our Locum Toolkit for more ideas.

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Updated on 21 February 2019 2927 views