What is NCAAD?


NCAAD is a three-year improvement programme, which was established to improve the quality of NHS-funded care provided to service users with anxiety and/or depressive disorder in England.

It was developed following the findings of the National Audit of Psychological Therapies for Anxiety and Depression (NAPT) which took place between 2010-2014.  

NAPT was established to evaluate and improve the quality of psychological therapy treatment received by people with anxiety and depression in England and Wales.  

After two rounds of data collection and a review of the findings and recommendations, a decision was made to refocus and expand the scope of the audit to look at the care and treatment of service users with a primary diagnosis of anxiety and/or depressive disorder within secondary care services.  

Towards the end of 2019, the Royal College of Psychiatrists had been working to secure funding from NHSE/NHSI in order to extend the audit for a further two years and implement the prospective audit we had been piloting.

NHSE/NHSI decided not to extend the NCAAD contract, on the grounds that it was not possible to adjust/alter the current audit sufficiently to underpin key components of the NHS Long Term Plan. In particular NHSE/I were keen to extend the core audit to include a community focus and to explore specific topics related to anxiety and depression, but this could not be done under the terms of the current contract. Needless to say, this is a major disappointment and we appreciate that Trusts put a lot of time and effort into collecting and submitting data for the audit. The data Trusts submitted have been utilised and published in our first two reports with one more report to follow.

The audit will be updated on the HQIP Directory shortly and all resources linked to the audit will remain available on our NCAAD homepage, should you wish to use the tools for re-auditing your Trust data independently.

The NCAAD programme closed on 31 May 2020, but due to Covid-19 there have been delays to the publication of our final outputs. Please look out for the following publications over the next couple of months: 

  • publication of the second spotlight report, exploring the experiences of service users who had psychological therapy
  • release of a summary video, reflecting on the last three years of the audit

NHSE/I are committed to mental health featuring as part of the audit programme and are reviewing the potential of different topics that will  support priority areas of the Long Term Plan

Thank you again for all your support and if you have any queries please don’t hesitate to get in touch at NCAAD@rcpsych.ac.uk.


Our objective have been to:

  • enable Trusts/organisations to improve the delivery of care to service users receiving treatment
  • provide comparative data on the quality of care and service user outcomes following treatment
  • facilitate the development of effective quality improvement initiatives and share examples of best practice, enabling Trusts/organisations to make the best use of audit data.

The audit had three components:

NCAAD is commissioned by the Healthcare Quality Improvement Partnership (HQIP) and is part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) funded by NHS England. For more information about NCAAD's audit process please see Understanding Practice in Clinical Audit and Registries tool: UPCARE-tool 2019

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