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Injecting some audit into substance misuse services

Mill House, Brookfields Hospital, Cambridge CB1 3DF

Stephen Green, Health Policy Advisor

NHSE Anglia and Oxford, 6–12 Capital Drive, Milton Keynes MK14 6QP

Olwen Williams, Consultant

Anglia Clinical Audit and Effectiveness Team, Addenbrooke's Hospital, Cambridge CB2 2SP

Woody Caan^*

Head of Research & Development, Douglas House, 18b Trumpington Road, Cambridge CB2 2AH

^* Correspondence

The former East Anglia Regional Health Authority initiated a 3-year project beginning in 1993. This aimed to introduce audit skills and to promote sustained audit activity across a diverse group of statutory and independent sector drug and alcohol agencies. Prior to this there had been little interest in audit for this area of care and no good models of practice were available from elsewhere in the NHS which could readily be adapted to the needs of the Anglian services. Eventually 24 agencies collaborated in this project, which introduced a system of reciprocal peer audit between the agencies which was supported by a dedicated facilitator, a programme of auditor training, and an Agency Audit Representative Group to prioritise topics for audit and to agree common standards. Progress was very slow to begin with. By May 1995, 12 agencies had completed an initial audit of 2–4 topics each from a regional menu of 12 priorities. One year later, 12 more services have undertaken such an initial audit and nine out of the original dozen (75%) have completed their first ‘audit cycle’ with a re-audit of the same topics. There has been an increase in the number of agencies meeting all the standards in their chosen topics, and in the number of topics where all standards are met, wherever those topics have been audited. Two new practice guidelines have also been developed by the agency representatives.