Audit toolkit – Quality in Chronic Low Back Pain


Quality Standards are tools designed to help deliver the best possible outcomes for patients. Each Quality Standard comprises a series of specific, concise quality statements with associated measures that provide aspirational but achievable markers of high-quality patient care covering the treatment of a particular condition. They also form an important part in addressing the increasing priority being placed on improving quality and patient outcomes.

The Royal College of Chiropractors’ Quality Standards are designed to make it clear what quality care is by providing patients, the public, healthcare professionals, commissioners and chiropractors with definitions of high-quality chiropractic care. By providing a clear description of what a high-quality service looks like, clinics can improve quality and achieve excellence.

Quality standards encompass statutory requirements, best practice and existing clinical guidelines but they are not a new set of targets or mandatory indicators for performance management. They are, however, a useful source to form the basis of clinical audit and to identify priorities for future improvement.

The Royal College of Chiropractors’ Quality Standards are not mandatory but can be adopted in full, or amended to take into account local circumstances. They can be used in a wide range of circumstances, such as a source of identifying CPD or clinic promotion, perhaps when tendering for NHS contracts, or at a national level. They enable healthcare professionals to understand the standard of service that chiropractors provide and allow commissioners to be confident that the services they are purchasing are of high quality. Importantly, they also help patients to understand what service they should expect.

The Quality Standard for Chronic Low Back Pain provides a very clear set of criteria on which to base an audit of quality in relation to chiropractic care of Chronic Low Back Pain.

How to undertake the audit:

Round 1: Audit the records of your last 20-50 new patients, recording your findings using the excel checklist provided here (right click and ‘save as’ to download). Determine levels of compliance (the spreadsheet calculates this for you), reflect on your findings and decide upon and introduce changes in practice/procedure as required.

Round 2: Repeat with your next 20-50 new patients and review findings (note the second tab on the excel file).

Further rounds may be undertaken. Copy and paste the checklist into a new worksheet.


Chronic Low Back Pain Quality Standard (A4 page version)