Guide · checked October 2026
National clinical audits, NCAPOP and Quality Accounts explained
HQIP commissions the National Clinical Audit and Patient Outcomes Programme (NCAPOP) on behalf of NHS England, the Welsh Government and others; the NHS Standard Contract requires providers to take part in relevant national audits, and Quality Accounts must report which ones they took part in.
NCAPOP
HQIP says it commissions NCAPOP on behalf of NHS England, the Welsh Government and others, managing the full commissioning cycle including procurement and contract management. The programme contains national clinical audits and clinical outcome review programmes. HQIP's FAQs add that NHS trusts fund a proportion of the costs through subscriptions.
Not every national audit is in NCAPOP. NHS England's Quality Accounts list marks which programmes are, and some major national audits are commissioned separately.
The contract
The 2026/27 NHS Standard Contract service conditions (SC26) require the provider to take part, where relevant to its services, in any NCAPOP programme, any other national audit or outcome review programme managed or commissioned by HQIP, and any programme on the NHS England Quality Accounts list for the contract year. It also requires audit data to be made available for consultant-level outcome publication and the HQIP-NCAPOP outlier guidance to be followed.
What Quality Accounts must report
- How many national clinical audits and national confidential enquiries covered the provider's services.
- The percentage the provider took part in, with lists of those it was eligible for and those it joined.
- Cases submitted as a percentage of the number required.
- The number of national and local audit reports reviewed, and the actions planned as a result.
These items come from the Schedule to the NHS (Quality Accounts) Regulations 2010.
What this does not mean
- The Quality Accounts regulations require reporting on participation; the duty to take part comes from the contract.
- Local audit is not optional just because it is not national: CQC's Regulation 17 expects systems such as regular audits.
- Case ascertainment matters: reporting "took part" with a low share of required cases still shows up.
Where Oriel fits
Oriel is for the local audits that sit alongside national programmes: the checks a department runs against its own procedures and national standards, and the evidence behind its Quality Account entries. It checks every case in the period, keeps who decided what, and drafts the report for sign-off.
Oriel does not submit data to national audits or registries. It is a pilot on synthetic data only.
Questions
Who commissions NCAPOP?
HQIP, on behalf of NHS England, the Welsh Government and others.
Do trusts have to take part in national audits?
The NHS Standard Contract requires providers to take part in relevant NCAPOP programmes, other HQIP-commissioned programmes and programmes on NHS England's Quality Accounts list.
Sources
Official pages, checked October 2026. Guidance changes, so check the current version before you rely on it.
General information for healthcare managers and clinical teams, checked October 2026. It is not legal, regulatory or clinical advice; follow the current official guidance and your organisation's own policies. No patient data is used in these examples. Oriel is a working prototype shown on a fictional demo hospital with synthetic data only. It is not a medical device and is not for clinical use. It drafts and flags for people to decide; it does not diagnose or change clinical records. A clinical safety case and information-governance approval come before any use with real patient data. Oriel is a working name.