Case study: Driving improvements in healthcare through robust nhs audits

Written by Georgina Nock on Tuesday 6th June 2017

pH Associates Ltd (an OPEN Health company) and Cisiv Ltd combined best in class consulting services, RWE expertise and fit-for-purpose technology, which delivered value both to AbbVie and to NHS Trusts. This article highlights how this partnership achieved the best results.


The Treat-to-Target recommendations for the management of rheumatoid arthritisaim to achieve high remission rates and improved function. A national UK audit was conducted to assess how well NHS Trusts were following international recommendations.


In 2010, an international task force developed therapeutic recommendations on treating rheumatoid arthritis (RA) to target. The aim of these ‘Treat to Target’ (T2T) recommendations was to improve RA management and clinical outcomes for patients. The challenge was then to assess how well these recommendations were embedded in standard clinical practice in the UK, and whether the recommendations (or the practice of auditing) drove improvements in practice.


A steering committee of rheumatologists worked with AbbVie to develop a national audit of secondary care NHS rheumatology units. The audit was aimed at establishing the compliance with the T2T recommendations and included data from 38 NHS facilities in elation to 1,571 newly diagnosed RA patients.

pH Associates (an OPEN Health company) consulted with NHS clinicians to develop an audit tool which would meet their needs, deliver data periodically and ultimately answer their clinical questions. Over a 6 month period, assistance was provided to gain appropriate NHS permissions and the audit was then rolled out nationally.

pH Associates and Cisiv worked closely to design the optimal electronic platform to collect data directly from clinicians. For a minimum of 12 months, data on disease history, management and outcomes were collected at each visit the patient attended the NHS facility.

Cisiv ensured that the data collection tool was intuitive, streamlined and easy to use. In addition, the platform enabled NHS sites to have real-time access to their own data.


Compliance with the T2T recommendations was established and monitored from 2012-2016, resulting in local NHS trusts being able to benchmark themselves against the national standard and drive improvements in patient care. The wealth of real world evidence collected has demonstrated the value of the T2T recommendations in practice. Indeed, NHS Trusts used the audit data to generate business cases to improve departmental structure and resourcing. The partnership between pH Associates and Cisiv combined best in class consulting services, RWE expertise and fit-for-purpose technology, which delivered value both to AbbVie and to NHS Trusts.

For further details of pH Associates (an OPEN Health company) and its Real World Evidence (RWE) offering, please get in touch with Georgie Nock, Management Consultant & Training Manager at pH Associates: or  01628 481 112