BICA Audit templates
Audit as a way of reviewing and improving the quality of care to patients and clients
has become established practice within the NHS. It is a subject that is of increasing
interest and importance in the wider health professions field, including counselling.
BACP emphasise the importance of audit…
‘Audit and evaluation are considered crucial for developing counselling services and may
be used both as ways of increasing counsellor efficacy and as methods of meeting the
quality demands of purchasers’(users and regulators). [Guidance for Best Practice:
Employment of Counsellors and Psychotherapists in the NHS].
…and as quality standards are now the norm for licensed treatment services their
application to counselling services is as essential as to any other form of provision.
The BICA Exec has consistently promoted the importance of maintaining data on
counselling provision and in 2006 published specific guidance on the detail that is
expected in an annual audit of practice [BICA Guidelines for Good Practice in Infertility
Counselling 8.10 (ii)].
Essentially, audit and evaluation involves
1. Systematic examination
These processes allow us to:
• find out what we are doing now
• compare it with what we have done in the past
• identify trends
• identify what works well / not so well
• plan what we may do / improve / develop in the future
• ensure we are doing what should be done and doing what we say we are doing!
• To comply with HFEA Code of Practice &
HFEA Standards for Assisted Conception Centre
• To meet BICA Guidelines for Good Practice &
BACP / FHCP Guidance for Best Practice
• To improve quality, effectiveness and efficiency
• To reassure service users and other stakeholders
• ISO requirement if centre is/proposes to be accredited
….and added value
• Keeps information up to date
• Provides ‘hard evidence’ - existing levels of service
- areas for development
- standards of good practice
• Systematically informs and educates colleagues / other health professionals
• Promotes professional credibility
• Sense of achievement in doing it and in the results it can show!
For some time, we have both wanted to see a greater degree of uniformity and higher
standards in counsellors’ annual reporting to the HFEA. When we were appointed as
HFEA External Advisors in 2005, we became acutely aware of the wide variations in the
reporting practice of infertility counsellors and the need for more specific guidance on
this important aspect of our work. In May 2006, at the annual BICA Study Day, we co-
facilitated a workshop on audit and resolved to draft audit templates for consultation
initially and then use by the BICA membership in LCT practice.
The gestation of these templates has been a long one but we believe we have now reached
the point where we can confidently recommend, with the BICA Exec’s endorsement,
both the Audit Template with Guidance notes and the Client Evaluation Questionnaire.
We have tried to keep the Audit Template as simple as possible whilst still eliciting all
the basic information that would be needed to monitor and evaluate practice within a
centre providing the full range of treatment services. Of course, not all counsellors will be
working with all categories of clients but it is expected that counsellors will adapt the
basic format to suit their individual practices; a note to this effect is in the accompanying
As you are all aware, the HFEA are keen to have clearly identified standards to assist
them in inspecting counselling services. Our aim in drafting these templates is primarily
to support counsellors in monitoring and evaluating their practice in a standardised
format approved by their professional body. Use of the templates will, of course, also
provide the HFEA with evidence of the quality and range of counselling service delivery,
in and between licensed centres. This is very important, given BICA's commitment to the
promotion of the highest standards of infertility counselling. We are all aware of the
marked / significant discrepancies that exist across centres particularly in relation to
patients' access to counselling [eg charges, availability, waiting times, restricted
provision]. The information should be of use to both the individual counsellor in, for
example, identifying service development needs (and providing evidence to support your
case with line management) and to HFEA Inspectors in identifying gaps in service
provision, including providing evidence to substantiate any resultant recommendations to
These templates were introduced to the HFEA Inspection team in November 2008, as
BICA's recommended tools for effective monitoring and evaluation in infertility
counselling practice [in line with HFEA COP guidance re audit and client feedback],
during our delivery of a counselling inspection training workshop.
In future, production of an annual counselling service audit and client evaluation analysis
in these formats will provide some of the essential evidence you will need in order to
demonstrate compliance at a licensed centre inspection. A written report, summarising
the major outcomes and trends, and identifying areas for improvement and / or
development, will be expected to accompany the audit material.
The templates will be reviewed annually and your feedback will be essential if we are to
ensure that BICA’s audit and evaluation tools remain ‘fit for purpose’. In the interim, we
welcome any comments you may have so please email us at
email@example.com or firstname.lastname@example.org
Sheila Pike and Kate Grieve