As part of delivering high-quality, innovative and safe services, HIV service providers routinely engage in quality improvement, clinical audit, service reviews and the evaluation of serious incidents and deaths through mortality and morbidity reviews. The outcomes of these exercises are critical to the provision of patient care since they are used to assess the quality of care received by patients; inform the commissioning of services and development of clinical guidelines; and drive clinical research.
Monitoring and audit
Clinical audit and service evaluation are key drivers for improving the quality of HIV care by checking whether current best practice is being followed and identifying where improvements should be made.
Individual review and investigation is warranted for serious incidents involving major consequences for patients, families or carers and/or substantial potential for learning, including some cases of late HIV diagnosis. Review of care provided to people who die can be revealing and should include all deaths among people known to have HIV.
Creating new knowledge and finding the most appropriate ways to use existing knowledge are vital for progress in the HIV field. Research and innovation underpin the understanding and response to HIV, the way treatments are provided to people living with HIV, and the improvement of prevention, treatment and outcomes for people living with HIV.
People living with HIV should be cared for by services that are commissioned based on robust and appropriate needs assessments. Service delivery and quality assurance should be in line with and monitored against relevant local and national service specifications. Services and commissioners should work together to ensure that the data required to plan and commission services are appropriately shared. The complexity of HIV, the range of care services required, and the number of commissioning bodies involved mean that commissioners should work together to plan provision across the entire care pathway. Commissioners of services used by people living with HIV should have formally established processes in place to ensure the active involvement of people living with HIV and vulnerable population groups.