Participation in audit is an essential part of anaesthesia training, which enables trainees to reflect on and review their practice and improve the delivery of anaesthetic services. 

There is increasing recognition given to the value of using audit to drive meaningful change. Involving doctors in meaningful quality improvement projects develops their leadership and organisational skills and improves the quality of NHS care. The competencies involved with quality improvement projects can address the Medical Leadership Competency Framework (MLCF)³², which describes the leadership competences that doctors need to become more actively involved in the planning, delivery and transformation of health services.

The publication, in 2012, of the “Raising the Standard: a compendium of audit recipes The Royal College of Anaesthetists for continuous quality improvement in anaesthesia”³³, spear-heads a transition from audit into quality improvement. This edition of the ‘recipe book’ intends to facilitate and strengthen the link between audit and improvement, by providing anaesthetists with an introduction to the science of improvement and demonstrating some basic tools which can be used to drive positive patient centred change. A number of doctors throughout the UK are conversant with improvement methodology, often from participation in one of the national or regional patient safety programmes.

The methodology of improvement has been incorporated in the curriculum as a way of supporting and adding value to audit, and to formally recognise improvement activity. The module of training is entitled “Improvement Science, Safe and Reliable Systems” and can be found in Annex G.

The RCoA expects trainees to participate in a quality improvement project, and by formally recognising this in the CCT Curriculum and by evaluating a trainee’s endeavours in the realms of improvement, it will enable credit to be given. This training augments existing audit mechanisms in using data to drive meaningful change, and can be assessed through local processes as per the latest edition of the ‘recipe book’. This volume provides a useful starting point to stimulate trainees’ interest across many subspecialty areas.