Quality Improvement Activity

A quality improvement activity for revalidation requires you to demonstrate that you regularly participate in activities that review and evaluate the quality of your work. It can take many forms depending on the roles you do and the nature of your practice.

For doctors connected to FPH for revalidation, we expect:

  • Evidence from an audit at least once per revalidation cycle
  • Evidence from two case reviews in other years where an audit is not done


It is accepted that traditional clinical audit is not a common occurrence for many public health specialists, and nationally led audits in public health are a rarity. We understand an audit as a loop, i.e. the audit must be completed to demonstrate an outcome, or change (if any) was made as a result of the action plan. You can use the audit template to document your quality improvement activity

Case reviews

The intention behind this requirement is to bring two examples showing that you review your daily work – examples which are significant and from which you have learned something important and outlining the impact it has on your practice. The term ‘case’ comes from clinical work, because the daily work of clinicians is seeing patients. In public health work that concept – the daily work – may translate into a wide variety of activities: meetings, outbreaks, events, projects and so on. Case reviews must show reflection against national standards or guidelines and include evidence of discussion with peers or presentation at department meetings. You can use the case review template to document your quality improvement activity.

Guidance and example

When discussing quality improvement activity at your appraisal, you will need to prove that you have evaluated and reflected on the results of your activity. You should also prove that you have taken appropriate action arising from the outcome of your results. Finally, following the activity, if an improvement has occurred, you should demonstrate that it is being maintained, this may require a repeat of the activity or a re-audit, after an appropriate period of time.

We have written a guidance document which includes examples of audits and case reviews. You can read it here.