It will give each level of the NHS – including individual clinicians in primary and secondary care – the information needed to help them compare themselves to their peers, and to monitor performance against agreed clinical standards.

NCASP will provide the infrastructure to collate local clinical data for analysis and feed back. It will help make comparisons with similar services and patients elsewhere, whilst still enabling local ownership of clinical audit information.

In collaboration with the Department of Health, PHSMI is building on existing work to develop a co-ordinated, consistent and comprehensive approach to providing clinicians with comparative information. We are working in partnership with other national bodies and clinical audit projects. This national programme will incorporate:

guidance on local data collection protocols;
endorsement of new and existing clinical datasets for local use;
safeguards for security and confidentiality;
use of NHSnet as a transmission mechanism, and;
the development of analytical tools and other techniques to provide feedback.

We are now rolling out a clinical audit service for acute myocardial infarction and paediatric cardiac surgery (the Central Cardiac Audit Database) to all cardiac centres across the country. This service will be extended to adult cardiac surgery and angioplasty by 2002. After that, the programme will target lung and breast cancer, followed by mental health, diabetes and stroke, in 2002-2003.

Quality first
A high quality comparative data service demands rigorous standards of data security, confidentiality and transmission. PHSMI is collaborating with professional bodies and health communities to:

provide a robust and consistent information infrastructure;
develop national information standards for clinical audit databases, and;
support existing audit services in their transition to the national standards.

In addition, the project will develop data analysis processes that are clinically led, risk adjusted and statistically sound. Information derived from third party data will be fed back to the data owners.

Links with other programmes
By its very nature, NCASP cuts across many other NHSIA projects, and there are a number of opportunities to co-operate on programme delivery. These include links with several programmes in the Personal Health area, including:

the Electronic Record Development and Implementation Programme (ERDIP);
clinical dataset developments;
clinical messaging, and;
support for confidentiality and patient consent.

This co-operation is focussing initially on some condition-specific work around lung cancer and coronary heart disease.

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