Clinical Audit vs Quality Improvement Project: What NHS Shortlisters Want to See
Updated: 2 days ago
"Involvement in clinical audit or quality improvement" appears on almost every NHS person specification, from junior clinical fellow posts to consultant jobs. Yet many international medical graduates are unsure of the difference between an audit and a quality improvement project (QIP), or how to describe their project so that it earns marks. This guide explains both in plain English.
Quick answer
A clinical audit measures practice against an agreed standard and re-audits after a change. A quality improvement project (QIP) tests small changes, often with PDSA cycles, to improve a process or outcome. NHS shortlisters want either one, described with your role, the data and what changed.
What is a clinical audit?
A clinical audit measures current practice against a clear standard, such as a NICE guideline or a local policy. You choose a standard, collect data, compare what is happening with what should happen, make changes, and then measure again. That final step, the re-audit, is what "closing the audit loop" means.
A simple example: checking whether patients admitted to a medical ward have a venous thromboembolism (VTE) risk assessment within 14 hours, as NICE recommends. If only 62% do, you introduce a change, teach the team and re-audit three months later.
What is a quality improvement project?
A QIP aims to improve a process or outcome through small, repeated tests of change. Instead of a single before-and-after measurement, you test an idea, study the result, adjust and test again. This is usually done with Plan–Do–Study–Act (PDSA) cycles, and progress is often shown on a run chart.
For example, a team might try a new handover checklist for one week, look at how many tasks were missed, improve the checklist and test it again.
The key differences
Starting point. An audit starts from a standard. A QIP starts from a problem or an aim, such as "reduce missed bloods by 50% in three months".
Method. An audit measures, changes and re-measures. A QIP makes several small changes, measuring as it goes.
What shortlisters look for. For an audit, they want to see that you closed the loop. For a QIP, they want to see cycles of change and a measurable improvement.
Both count as evidence. What matters most is that you can explain your role, what changed and what you learned.
How to describe your project on an NHS application
Shortlisters score your description, not the title of the project. A strong paragraph includes the standard or aim, your role, the result in numbers, the change you made and the re-measurement. For example:
"I carried out an audit of VTE risk assessment on admission against the NICE standard and found that only 62% of patients had a completed assessment within 14 hours. I presented the results, introduced a prompt on the clerking proforma and taught the admitting team; a re-audit three months later showed 91% compliance."
If your project is still in progress, say so honestly and explain your plan. An unfinished but well-designed project is still good evidence.
If you have not done an audit yet
Many IMGs arrive in the UK without an audit they can describe. You can start one in your first post, and you can learn the method before you begin. Our free Audit and QIP Ideas tool suggests project ideas for your department and builds a step-by-step plan, a report and a ready-made PowerPoint. Our free online Clinical Audit and QIP course explains audit cycles, PDSA and run charts, shows you how to write your project for an NHS application, and gives you a verifiable certificate of completion when you pass.
Audit links closely to Clinical Governance, which many person specifications also ask about.
Key points
An audit compares practice with a standard and closes the loop with a re-audit. A QIP tests small changes in repeated cycles. Either can score well on an NHS application if you explain your role, your results and what changed. If you would like your audit or QIP paragraph reviewed against a person specification, contact CareerPro UK.
Frequently asked questions
What is the difference between clinical audit and a QIP?
Audit checks practice against a set standard and then re-checks after a change. A QIP uses repeated small tests of change, such as PDSA cycles, to improve a process.
Which is better for an NHS application, audit or QIP?
Either can score well. What matters is a completed project, your specific role, real numbers and what changed as a result.
Can I include an audit I did outside the UK?
Yes. Describe it in the same way, with the standard, your role, the results and the changes made.
How do I describe an audit on my application?
State the topic and standard, your role, the results of the first cycle, the change you made, and the re-audit result.
Last reviewed: October 2026. Read how we research and update our guides.
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