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GPs buried under trusts' workload dump

No extra work under QOF2

Summative assessment examiners will scrutinise your audit project against a number of clearly defined criteria. At least two examiners will look at your audit in the first instance.

If they are both satisfied that you have met all the criteria, you will pass. If this is not the case, your audit will be referred to second-level examiners. If they agree that your audit is deficient in some areas, it will be returned to you and you will need to resubmit.

Paying attention to each stage of your

audit will greatly reduce the chance of it being returned as unsatisfactory.

Setting criteria and standards are often terms that registrars get confused ­ this is a common and avoidable reason for an audit to be returned for resubmission.

· Make sure your audit criterion is a specific statement of what ought to be happening ­ 'All adult diabetics should have annual retinopathy screening'.

· Do a literature search to ensure that your criterion is evidence based.

· Don't try to include too many criteria at once ­ one or two will be sufficient.

· Define your terms, eg what is an adult?

Next, set the standard ­ this should be the minimum acceptable level for the criterion you have just chosen, eg '90 per cent of adult diabetics should have attended for retinopathy screening in the past year'.

· A standard of 100 per cent would be unusual, as it is difficult to achieve perfection. Standards should be set and justified accordingly.

· The greater the importance of the criterion, the closer the standard should be to 100 per cent.

· Collect the data, and don't forget that this is another way of involving the practice team.

· Present your results clearly. These could be in a table or a pie- or bar-chart. Account for any missing data.

· Compare your results with the standards you have set. The next parts require you to show you have reflected on what you have found, and what needs to be done to improve matters.

· Try to think of a number of reasons why you have not met the standards initially,

if this is the case. These may be due to patient factors, doctor factors, or organisational factors.

· Think of changes that could or should

be implemented to ensure you have a better chance of meeting the standards. These must be practical, and some of them at least should be achievable in the time you have got to complete your audit cycle.

· Describe at least one actual example that you have carried out.

· Re-audit, and present the results of the second data collection.

· Draw your conclusions, and summarise the main issues you have learned. Keep to the point, and remember the title of your

audit project ­ you do not want to lessen the impact of your findings and discussion by putting in a lot of unnecessary padding.

Lastly, don't forget your references:

· Important statements of fact should be referenced, and not appear to be simply your opinion.

· Make sure references are from peer-

reviewed journals, and not from out-of-date textbooks.

· List your references in a consistent way, linking the text of your audit with a well laid-out reference section at the end.

Mei Ling Denney is a GP in Peterborough, and an examiner for summative assessment and the MRCGP

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