📈 QIA vs QIP: What’s the Difference (and What Do You Actually Need to Do?)

    

If you’ve found yourself wondering “What’s the difference between a QIA and a QIP?”,  you’re not alone. This is a common point of confusion in GP training.

But once you break it down, it’s actually pretty straightforward, and your portfolio only needs one full QIP during training (plus two QIAs). Here’s everything you need to know 👇

       

🔑 Key Learning

• You must complete 1 Quality Improvement Project (QIP) and 2 Quality Improvement Activities (QIAs) during GP training.
• The QIP should be done in a primary care post (ST1 or ST2) and uploaded to fourteenfish
• QIAs are shorter reflections on activities that improved care or systems - log them in the QIA category in your Learning Log.
• You’re expected to demonstrate involvement in some form of quality improvement every year of training.

     

🛡️ Clinical Governance & QIA/QIP

Clinical governance is the system NHS organisations use to ensure safe, effective, and continually improving care. It includes elements like:

• Education and training
• Risk management
• Clinical effectiveness and audit
• Openness and learning from mistakes

🧪 QIA and QIP are part of this framework:

• QIA = small-scale reflections or changes to improve care
• QIP = structured projects with data collection and measurable outcomes

By doing QIA/QIP, you’re actively contributing to clinical governance, not just ticking a box, but helping improve systems and patient outcomes.

      

🧠 What is QI?

Quality Improvement (QI) in general means:

“Using a structured approach to improve patient care, safety, or systems of work.”

This could include:

• Reviewing how something is done
• Identifying a problem or inefficiency
• Testing a change to improve it
• Measuring whether the change worked

       

🔍 QIA vs QIP – What’s the Difference?

    

🌱 Quality Improvement Activity (QIA)

A QIA is a broad umbrella term covering any learning activity that demonstrates you're engaging with quality improvement in your clinical work. It’s less structured than a full audit or QIP and doesn't require repeated cycles of change.

It might be:

• A single-cycle audit (e.g. reviewing prescribing patterns once and reflecting on them)
• A case review highlighting a safety issue you noticed and improved
• A coding review to identify inconsistencies
• A reflection on patient feedback leading to change

✅ Key features of a QIA:

• No requirement for repeated data collection
• Doesn’t need a full PDSA structure. Instead, the ‘QIA’ reflection requires the following:
  • Brief description (e.g. the issue at hand, and what you did)
  • What were you trying to accomplish?
  • How have you engaged with others?
  • What changes have taken place?
  • Reflection: what will I maintain, improve or stop?
• Focus is on identifying an issue, engaging with it, and reflecting on learning or change
  

🧠 Think of QIA as quality improvement “lite” - still useful, but less formal

           

🧪 Quality Improvement Project (QIP)

A QIP is a more formal, structured project. It is completed once during training, either in ST1 or ST2 primary care posts and should show:

• A defined aim (e.g. improving smear uptake in women aged 25–35)
• Baseline data collection
• A clear intervention (e.g. recall letters, phone calls, posters in the waiting room)
• Re-audit or second data collection (to see if the intervention made a difference)

This is often what people mean when they refer to “doing an audit,” but with modern QIP methods, it’s broader than that - you could use patient feedback, systems redesign, prescribing data, etc.

✅ Key features of a QIP:

• Involves a specific intervention/change
  
• Requires at least 2 data collection points (before and after)
• Should use a structured framework, e.g. PDSA (Plan–Do–Study–Act)
• Must be written up clearly in the QIA/QIP section of the portfolio
• You’ll upload evidence answering the following questions:
  • Why did you choose this project?
  • What was the aim of the project?
  • Describe what baseline data or information you gathered
  • Describe what subsequent data or information you gathered
  • How did you plan and test out your changes?
  • How have you engaged the team, patients and other stakeholders throughout the project?
  • Summarise the changes as a result of your work and how these will be maintained
  • What have you learnt and have you got any outstanding learning needs?

🧠 Think of QIP as a mini research project – you’re testing a change and then proving whether it worked

          

🧠 An example..

• QIA = Spotting something wrong with your clinic’s appointment reminders, talking to the admin team, and reflecting on what could improve
• QIP = Collecting no-show rates over 3 months → introducing a new SMS reminder system → collecting no-show data again → analysing improvement

       

Feature	QIP (Project)	QIA (Activity)
💼 What it is	A full, structured project designed to improve quality in a measurable way	A smaller activity or reflection on something that improved patient care or processes
📍 Where	Should be done in a primary care post (ST1 or ST2)	Can be done in any setting
📅 When	Once during training (ST1 or ST2)	Twice: Once per year in the other 2 training years when you didn't do a QIP.

          

📝 Need inspiration?

💡 Review our article 101 QIA Ideas for GP Registrars

           

🧠 Be SMART - Tips for Writing a Good QIP

• 🎯 Specific: Focus on one clear change (e.g. “increase flu jab uptake in over 65s”).
• 📏 Measurable: Use data (e.g. before-and-after percentages).
• 👥 Achievable: Keep it small-scale and realistic.
• 🔁 Repeatable: You should have measured change over time, ideally using the PDSA cycle (Plan, Do, Study, Act).
• 📆 Time-bound: Make sure you set a timeline (e.g. “within this placement”).

         

💡 Tips for Getting Started

• Ask your supervisor early in your GP post - they may already have a project idea or data you can use.
• Speak to your team - they often have QIP ideas waiting for someone to run with.
• Keep your project small but focused - something achievable in a 6-month post.
• For QIAs, don’t overthink it - if you’ve identified an issue & contributed to improving it, reflect on it in your log.

            

📝 Registrar ‘To Do’ Checklist

✔️ [ ] Complete 1 QIP in either ST1 or ST2 primary care posts
✔️ [ ] Complete 2 QIAs in your other training years

                 

🔗 Useful Links & Resources

• 📄 QIP Template - RCGP
  
  
• 📘 RCGP WPBA QIP & QIA Guidance
  

              

Feeling stuck for inspiration? Our next article brings you a huge list of realistic, achievable, and portfolio-friendly ideas for QIA and QIP projects - tailored specifically for GP trainees. From quick wins to impactful audits, you’ll find something you can start this week.

➡️ Read: 101 QIA Ideas for GP Registrars