Abstract

OBJECTIVES--To investigate the approaches to audit of different medical audit advisory groups (MAAGs) and to consider the implications for evaluation of their activities and their developing role in the light of new priorities for clinical audit. DESIGN--Qualitative study based on semistructured interviews. SETTING--15 family health services authority (FHSA) districts in two English health regions. SUBJECTS--MAAG chairpersons and support staff and FHSA general managers and medical advisors in each district, totalling 68 subjects. MAIN MEASURES--Structures and activities of MAAGs; perceptions of the MAAG's role and its achievements compared with the initial brief in a health circular in 1990. RESULTS--The approaches of different MAAGs varied considerably: some concentrated on promoting audit and others were involved in a wider range of development activities. MAAGs assessed their progress in various different ways. The importance of collaborative working was recognised, but few interface audit projects had been undertaken. MAAGs had little contact with other quality assurance activities in the FHSA, and FHSA involvement in the MAAG strategy was variable, although MAAGs were taking steps to improve communication with the FHSA. CONCLUSIONS--Major differences exist in the approaches taken by MAAGs and the roles they fulfil, which will make evaluation of their effectiveness a complex task. Already MAAGs are responding to changing expectations about audit and pressure for closer links with management.