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A review of regional clinical and social care audit arrangements in Northern Ireland in 2005 found there was a need for a single regional audit focus in place of the two current committees NIRAAC and RMAG. The Department supported the recommendations for a single regional focus through their amalgamation and asked that further consideration be given to how to integrate the work of CREST in developing local clinical guidelines with the proposed new arrangements.

In August 2007 RMAG, NIRAAC and CREST became the Guidelines and Audit Implementation Network (GAIN) and will keep regional audit and guidelines in the forefront of service improvement.

GAIN will have an important safety and quality improvement role in Health & Social Care Services throughout Northern Ireland through the commissioning of regional audit and guidelines as well as the promotion of good practice through the dissemination of audit results, and the publication and facilitation of implementation of regional guidelines.

Under this new arrangement, regional audits will be commissioned by GAIN. There will also be a programme of regional guidelines development. Topic selection criteria for both regional audit and guidelines will shortly be disseminated by GAIN. However, it is anticipated that the focus will be on alignment of regional guidelines / audits to:

• regional priorities
• identified local gaps, especially those where no national guidelines / audits are available (or imminent) ,and / or
• specific regional safety or high risk issues that have been highlighted through various local and national systems and procedures.