Home » Improving


We’re improving health and care and leading the prevention of ill health across communities. Here are some highlights of our work in 2021.

We worked directly with physicians and their teams to support quality improvement initiatives and design person-centred services. Although things had to be adapted for the pandemic, our audit and accreditation programmes successfully supported many clinical services to aspire to higher standards. We developed new resources and involved patients and carers to help shape best practice.

Our work in numbers

Our key achievements

Audit and service review

The RCP continued to be commissioned by HQIP to deliver three national clinical audit programmes in 2021:

  • National Asthma and COPD Audit Programme (NACAP)
  • Falls and Fragility Fractures Audit Programme (FFFAP)
  • National Lung Cancer Audit Programme (NLCA).

We published nine reports on COPD, asthma, lung cancer care, inpatient falls, hip fracture care and fracture liaison services. Our new FFFAP patient involvement guide for NHS organisations shared good practice and tips.

Our invited reviews support healthcare organisations requiring independent and external advice. We completed 12 invited reviews during 2021, adapting them to run virtually.


We continued to assess the quality of clinical services through our accreditation programmes for endoscopy, allergy, pulmonary rehabilitation, primary immunodeficiency and liver services. These programmes went from strength to strength with 34 new services registering in 2021. Feedback highlighted that RCP accreditation is a valuable way to support the restoration of services following the impact of the pandemic.

We delivered 72 accreditation assessments either remotely or with remote and on-site elements. Early feedback from clinical and lay assessors indicates that the process has remained rigorous. We continue to seek and act on feedback to ensure we deliver assessments robustly and to high standards.

The JAG Endoscopy team launched updated standards, which streamlined the benchmarking process for services. A major new version of JETS, the JAG Endoscopy Training System, was developed and is due to launch in 2022.

The JAG National Endoscopy Database (NED) collects real-time clinical data from endoscopy reporting systems. NED began collecting data in 2016, and during 2021 over 5 million procedures were captured. We’re now exploring opportunities for this unique platform to support broader visions around transformation of endoscopy services and training in the UK.

Training and development

Our flagship Chief Registrar Programme supports doctors in training to lead service improvements in the NHS. It continued to grow in 2021 with over 90 participants from 57 trusts and health boards joining. Almost 250 medical trainees have completed this highly regarded development programme to date.

Over 500 trainees participated in our first virtual regional poster competition to showcase outstanding projects and initiatives.

We worked with the NHS Getting it Right First Time (GIRFT) Programme, patient-facing teams and the wider NHS to deliver a series of four webinars showcasing best practice and expected standards of care in acute medical pathways.

The NACAP developed local capacity to deliver improvement with a funding opportunity for respiratory care teams in England and Wales. Nearly 100 individuals from 37 participating teams completed online training in quality improvement skills and 14 people received training to provide coaching support to local teams implementing improvement projects.

The FFFAP designed and launched an improvement collaborative for clinical teams participating in its three audits: the National Audit of Inpatient Falls, National Hip Fracture Database and Fracture Liaison Service Database.

New guidelines and resources

We published a report on good practice for modern ward rounds and supported the implementation of its recommendations via an improvement collaborative with the NHS Emergency Care Improvement Support Team and Royal College of Nursing. Participating teams reported delivering improvements in multiprofessional patient-centred care on wards. Patient participation was key with our Patient and Carer Network (PCN) contributing to a series of national learning events to ensure the patient/carer’s perspective helped shape this improvement work.

As part of a focus on medicines safety, we launched a new toolkit to support medication safety at hospital discharge. In addition, we worked alongside the PCN to produce a checklist to support patients to use medicines safely when leaving hospital. It aims to help reduce medication errors in this important area of safety.

Our National Guideline Centre developed several significant guidelines that were published by NICE this year. These included atrial fibrillation, sleep apnoea, heart valve disease, and chronic pain and ME/CFS.

We published a study on the quality of care given to hospital patients with COVID-19 in the UK. Using retrospective case record review, it concluded that overall care was judged to have been adequate or better in 96.5% of the patient cases. The report made recommendations for the NHS and healthcare teams.