title: Completing the cycle: The use of audit to develop a mental health service in times of austerity.
abstract: BACKGROUND
  A published audit demonstrated that a pilot psychiatric clinic failed to capture predicted numbers of women with severe and enduring mental illness.
  
  
  METHODS
  On the basis of recommendations from this audit, along with those from the Royal College of Psychiatrists and NICE guidelines, a more comprehensive psychiatric service was developed to meet this demand and therefore manage risk more effectively.
  
  
  RESULTS
  Over the course of a year, the new service attracted a higher rate of referrals of pregnant women with severe and enduring mental illness. The majority referral source continued to be midwifery-led.
  
  
  CONCLUSIONS
  Audit is a useful tool for evaluating and informing service development and helped us identify further improvements needed to deliver an effective mental health service.
authors.affiliation: Highgate Mental Health Centre, London, UK.
authors.forename: Nisha
authors.initials: N
authors.lastname: Shah
authors.affiliation: Camden and Islington NHS Foundation Trust, London, UK.
authors.forename: Lucinda
authors.initials: L
authors.lastname: Donaldson
authors.affiliation: Camden & Islington NHS Trust, Highgate Mental Health Centre, London, UK.
authors.forename: Ramya
authors.initials: R
authors.lastname: Giridhar
keywords: High-risk pregnancy; audit; mental illness; service development