Example of a Practice Audit

Hello. I’d like to tell you a little bit about our audit that we performed here at Churchill Medical Centre for our programme where we were able to reduce antibiotic prescribing by 15% by using a programme of self-care and concentrating particularly on the duration of illness. We performed this audit initially by defining our patient group using the read codes that GPs were using at the time. So this was several years ago. And we asked GPs what read codes they were using, and used those as the basis.

The important thing about that is we were able to ensure that every patient was included, and also we were not imposing a set of read codes which people then had to learn with the risk that you can then miss some people. So we defined in detail which read codes were actually being used, and then on the basis of that we were able to establish who was getting an antibiotic and who was not.

And then three months later we were able to repeat the same search, and we were able to establish purely through our intervention where we were particularly concentrating on the duration and by introducing self-care we were able to establish that we were able to reduce unnecessary antibiotic prescribing by 15%. I think a couple of the important lessons, perhaps, that we were able to pull out from that, the first important one is that whenever we start an audit like this, we’ll always find we’re not quite as good as we thought we were. And the important element there is to actually learn from it and look at how we’re going to improve it.

So there’s always an initial shock when you think surely we’re better than that. And I think the other really important aspect of it was discovering just where we sat within the national range. And it has been suggested anything up to 60% or possibly more of patients will be receiving an antibiotic when they come in with a respiratory tract infection. Now, we were around 40%. So we were lower than any sort of national average. But we still felt there was a lot we could do. And certainly when we talk about the 15% reduction in antibiotics that we achieved, that’s from a relatively middling to low range to start with.

I have no doubt at all that the audit that we did, if it’s run in other practices, if they are looking at being near the national average, they can do even more through this process.