We’ve developed a new process for clinical audit, which builds on our well-established processes for other quality audits including internal and service provider audits.
Clinical audit is one of the quality assurance tools to support continuous improvement and high-quality screening programmes.
International evidence shows that robust clinical audit processes can help improve consistency and quality within screening programmes over time.
About clinical audit in screening
Clinical audit is a clinically-led quality improvement process. It helps us to identify areas where patient care is working well, and areas for improvement. Unlike other quality audits - such as internal, external, service provider and supplier audits - which focus on programme processes, system efficiency and compliance with standards, clinical audits are led by healthcare professionals to evaluate and improve direct patient care and clinical outcomes.
Where opportunities for improvement are identified, actions can be taken and services reviewed again to assess if those changes have made a difference.
Clinical audit in screening helps to:
- assess whether agreed standards are being met
- identify areas for improvement
- support safe, effective care
- improve clinical outcomes for our screening participants
- drive continuous quality improvement.
A national approach
Our new clinical audit process brings together national guidance, clear governance arrangements and a standardised approach to planning, carrying out and learning from clinical audits. It involves reviewing care or services against agreed standards and identifying if improvements are needed.
The process is aligned with the:
It involves different stages including setting criteria and standards, designing the audit, collecting anonymised data, analysing the findings, and developing and implementing a quality improvement action plan.
This structured approach helps ensure that audits are focused on learning and improvement, while also providing consistency across programmes and services.
Strong governance and oversight
We’ve developed a clear governance structure for clinical audit. We’ve established a new National Screening Service (NSS) Clinical Audit committee, with oversight provided by the HSE National Steering Committee for Clinical Audit. It sets out clear roles, responsibilities, oversight and accountability arrangements across the NSS.
Clinical audits are supported by internal and external expertise including programme, public health and quality, safety and risk teams in the NSS; and members of our Patient and Public Partnership - reflecting our ongoing commitment to ensuring that the patient voice remains central to quality improvement in the NSS. International experts in screening advise us on appropriate standards and assist with benchmarking our programmes against similar European programmes, where relevant.
This governance structure helps ensure that clinical audits are:
- appropriately approved and overseen
- carried out in line with best practice and legislation
- focused on quality improvement and participant safety
- aligned with programme quality assurance standards
- focused on implementing improvements where needed
- monitored through to completion
- in line with evidence-based international standards.
Turning findings into action
A key part of the clinical audit process is acting on findings. Where an audit identifies opportunities for improvement, recommendations and quality improvement plans are developed, implemented and monitored. Progress is reviewed regularly and, where appropriate, services are re-audited to assess whether the changes have achieved the intended improvements. This ensures there is continuous improvement - supporting safe, effective care and improving outcomes for our screening participants.
Looking ahead
By adopting a consistent, nationally aligned approach to clinical audit, we are strengthening our ongoing commitment to quality, safety and continuous improvement across all screening programmes.
Over time, clinical audits will provide valuable opportunities to learn, improve and ensure that our screening services continue to deliver high-quality care.
We’re now preparing to carry out a clinical audit in our Diabetic RetinaScreen (DRS) programme. The aim of the audit will be to assess if the DRS primary grading pathway is performing within accepted international standards for diabetic retinopathy screening.
As we mark Clinical Audit Awareness Week 2026, this work reflects our ongoing commitment to improve outcomes for people who choose screening.