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Hello, everyone. We will just give people another few minutes to join. Uh, we're just going to give everyone, um, maybe a couple more minutes to join. Mm. I don't know if people know about the sessions but seem, seems like, uh, hi, we're just waiting to see if we're gonna get a bit more people joining the session. Yeah. So I just wait until, like, 110 to start. So, just to give you time to, like, get into the room. Ok. Just because if the main stage is already started then people might not know about the break breakout sessions. Uh, sorry. Um, no one's starting on the main page, I think. Um, she was on the main page. All right. Perfect. Perfect. Yeah. Ok. I think once we have maybe five we can get started. Ok. Ok. I think we've got a bit more people. Um, I think I'll start just because I have a number of exercises in the room, um, that I would want people to do. Um, ok. And also the fact that it's a small group, I guess we will have a bit more time or opportunity for discussion, what I will do. Is I'm going to invite everybody to stage, which means you'll be able to speak. You don't have to turn your camera on. Uh You can only turn, you should, you don't have to, again, turn um your camera or microphone on, but it would make it easier if you want to speak or ask questions or um anything from uh of that sort. So again, don't feel like any pressure, I'm not gonna ask you to do anything. It just helps people. Um two be able to communicate better. So what I'll do is I'm going to share my screen. Once I share my screen, it will be very difficult for me to see who is messaging and if there are any questions, so tell, it will be my eyes on the chat. The plan that I have for this workshop is we will go through the different steps of getting an audit done and we will go through certain steps. Uh We have two exercises planned for everyone. We can do these as individual exercises, but it could also be done in groups and we will take you through the stages of creating uh conducting an audit. So can you can someone just um let me know if you guys can see the presentation? Yes, we can. All right, perfect. So it'll be myself and Tammy who will take you through this workshop. We're going to talk about clinical audits and we're gonna talk about quality improvement projects the differences between them and when which situations are best for which of the two. So, um the workshop will have about two of these questionnaires, a presession questionnaire and a postsession questionnaire. Uh They are quite important to fill out and the importance of that will come clear towards the end of the session. I'll take you through why that's important. So, uh if you just use the QR code and uh try and do that, it's very quick. It should take about a minute. So I'm going to set a timer for about 90 seconds. Um And the reason I want the reason it's going to be short. So it, it will have one identifier question. You can write your first name, your last name. Uh You can use any other anything that will help me identify you, but make sure you remember it because I'm going to ask you to use it again. Um And there are nine close ended questions. I've set a timer and then I'll give you guys time to, to quickly finish that. Um It really is important for you guys to, to, to try and do this and again, like I said, I'll bring that um the importance of that towards the end. Ok? 30 more seconds. Ok? 10 seconds. But I cannot open the QR code. It says it has been deactivated for some reason. Ok? Yeah, facing the same problem here, you guys are having the same. That's fine. What we'll do is uh we'll continue and when you guys are doing your first exercise, I will try and um update the QR Code. Ok, great. So, like I said in this workshop, we're going to talk a little bit very briefly about what clinical governance is. Um Actually, if you just bear with me a second, I'm just gonna stop sharing for a minute. I will continue to speak, but I'll just share the link while we do this. Um I think it will just be a little bit easier if we do it prior. The reason why we'll start talking about clinical governance is just to put things in context. Uh It, clinical audits and quality improvement projects are all part of a clinical governance framework. So I'll start by using that. So can you guys tell me if this link is now working? Um It, it will just make it a lot less biased if you're able to fill in the form before. Uh Just let me know if you can access it. Yes. All right. All right. So I'll just do another minute and then I'll go back to uh sharing my screen. OK? About 40 seconds. OK. 20 seconds. All right. So this um like I said, we'll talk a little bit about clinical governance. What clinical audits are a little bit about the difference between what a clinical audit is, what a quality improvement is and research and we'll do some activities uh there are three activities here, but I think we'll merge the 2nd and 3rd and then we'll just uh kind of close the big picture of quality improvements generally is that especially in health care is that we, there is a big gap between what we know and what we practice. So in England and Wales, one in every five deaths is avoidable. And by that, we mean exactly the knowledge that we have the resources that we have, that death could have been preventable if we just did what we already know. But what happens is sometimes there are a lot of different factors that come into play that makes us do care or provide care that is not the best that we could provide at that point. And this gap is where a lot of the audits and quality improvement projects aim to address the graph uh on the screen here. Scale is just a, just a, a kind of a um a graphic way we have there is our current performance, but we have the potential to improve and do better. And with a lot of the, the quality improvement projects, the idea is we want to give our patients uh the best care provided and we want to get the best from our staff. And this is helpful because it allows us to improve health and well being of our patients, minimize harm to them. Uh We will have a well trained workforce, our environment of work. Will be safe and supportive and we want to get sufficient resources to be able to get the best from our patient and the best of our staff. This all falls in the context of clinical governance. This is an important question that's often asked in a lot of specialty recruitment interviews. What is clinical governance and the definition is quite worthy? But if you remember four key points, you'll be able to explain the concept very well. So the idea is we want to provide high standard of care and we want to continue to improve on these standards and to make sure that NHS organizations do this, we have to make them accountable to the public and to um uh to, to basically to the public. Uh And then we want to emphasize that to get all of these improvements, we need to focus on the NHS environment rather than individuals. And once you understand that again, this is a general thing. We want NHS organizations, we want to have a good and supportive. And the reason we want to do this is this allows us to give our patients the best care and we will continue to improve on this care. And just going back, we will, the idea is we will be able to bridge this gap. Uh Of course, patients dying, this is inevitable in a lot of cases, but we don't want to have death that could be prevented. There are seven pillars of clinical governance pirates is the most common acronym use. But there are a lot of others and they basically, I'm not gonna go through them just because of time. But the idea is we want to start with patient and public involvement. We want to prioritize what matters to patients. And that would be an important thing in the philosophy of our um our, our, our hospitals, but also in the GMC, it's always about make the care of your patient your first concern. So you really prioritize what's important to patient. Uh You want to minimize risk to patients in a clinical environment and these are things like medication errors, infection control. Uh You also want to make sure that you're auditing the carrier providing and your, to improve that you want to train your uh doctors or your health care providers so that they're continuously updating their knowledge and adhering to the best evidence. Uh And when there are knowledge gaps where we don't know what is the best thing you want to do research, you want to continue to improve in that and you also want to manage your staff because at the end of the day, the staff are the ones who are providing this care. So why should we be interested in audits? It's part of your duties and responsibilities. Uh As a doctor, you want to provide safe care to your patients and good quality care and audits are an integral part of this But also when you continue to do audits, when you continue to provide uh the best care for your patients, then they will have ultimately better outcomes. Doctors get to practice better medicine, they get to practice evidence based care. They get to comply with regulatory uh standards and reduce error as a result. So they have better practice in general. And for the NHS, we, we get better outcomes. Uh and we also are mo a lot more efficient in using our resources. And another thing that is uh and I hope you understood, you can appreciate why is because audit and quality improvements are very important for day to day practice. They play a big part in portfolios and for your A RCP requirements because we, within the NHS, we want our doctors to really be able to um engage in these uh activities. There are so many different activities for uh quality improvements, clinical audits and quality improvements, which are one and two in this graph are the most important ones. And these are the ones that we'll talk about quickly in this workshop. So an audit is basically a quality is, is uh an established quality improvement and assurance techniques and what it does, it allows us to measure current care against an agreed best practice. And this is a standard. It's uh high quality audits is an ongoing cyclical process where substandard care is rectified by implementing small changes over time. So basically when you were talking about an audit. We're talking, talking about a clear standard. So this standard could come from research evidence could come from expert consensus. But we have a specific standard. We say everybody has to adhere to this standard. And when we do the audit, we go back and we see how many people or are there instances where we did not adhere to the standard? And it's important in an audit to understand why we've not been able to adhere to the standard because that allows us to then uh design specific changes that are very specific to these reasons. And this should help us improve over time. People often talk about an audit cycle. An audit cycle is a reasonable target for people to get involved and do. But an audit process is a lot more uh complex, not complex is a lot, it's so an audit doesn't end in a cycle. Uh but a cycle is a complete uh section, but usually you want to continue to do an audit over and over and over and over. So it's more of an audit spiral, but individual people can contribute to one cycle in that audit. Um And the reason why it's more of an audit spiral is because when it usually the standards are quite ambitious and small changes, you need a number of small changes for it to change and for people to adhere to the standard. So every audit cycle should, in theory improve adherence slightly and you need to go back, understand what happened and improve on it. And even if you reach high standards, so 100% compliance, for example, you want to ensure that you maintain this. So you continue to audit, there are different types of audits, audits could be prospective retrospective. So you could either look at what and see what if, for example, if certain changes happened in the past, you can go back and see what, what people have done. Uh and it can be prospective. You can um start with a s you can start by assessing, then you can do um implement some changes and then you can audit again and then the audits could focus on things like the structure uh of the en the environment you're in on processes on outcomes. And they could also be based on the location, whether this is in a community setting, in a GP setting or in a hospital setting, uh a a little bit about structure versus process versus outcome. So for example, in an audit, when you're trying to audit some structure, you're, for example, you're looking at um uh consultation rooms, seeing if they're soundproof, you want to see if you know, you want to make same patients confidentiality. So you can do an audit to see uh how many of the consultation rooms are private or how many of the consultations happen in soundproof rooms. Um You can look at, for example, staffing levels, you can look at equipment to see if for example, the um the emergency trolley is always uh the different relation trolley is always well stock. You can also do audit processes like triage screening and you can try and audit outcomes such as mortality, morbidity and things like that. So the audit, the idea of an audit is very wide encompassing and it can look at everything that affects patient care, either directly or anything in the process. So there are a few differences between an audit and quality improvement project and a research with a research. You're aiming to prove something, you have a hypothesis and you want to prove that you want to produce new knowledge. However, with an audit and quality improvement, you want to improve current care and you want to improve current practice, but you go about them uh in different ways. So I've provided a few examples here. A research question would be in women who have dense breast. What is the best way that we can screen their uh can screen them for cancer? Should we do a mammography or should we do a mammography and ultrasound? And in this situation, uh you, we don't know which is which. So we have to then do a research project to try and collect data and understand which is better. But an audit would say, well, the best practice is we need to give, we need to scan women using this and in our audit, we want to uh measure current practice. Every woman that comes in or every patient coming in to have their breast screened for cancer. Are we screening them according to the best evidence? So we're not really producing uh new general knowledge, but we're trying to understand our, we met following current practice with a quality improvement project, we don't actually have a standard. There isn't a clear best practice, but we're trying to improve what's going on. So let's for example, say not everybody is able to access the guidance to uh not every, not everywhere people for are are following best practice. So what we can do, what can we do to improve access to this best uh practice so that people can then follow it? Um And the questions we're trying to answer are very different in research. We're looking at what is the best scanning method in an audit. We're looking at how often do we use the best scanning method? And then in a quality improvement project, we are looking at if we do monthly teaching sessions or if we uh put implement any sort of intervention, does this improve adherence to the guidance regarding the best counting methods? Um there is overlap between them because they all really aim to do the same thing. So you could really research outcomes of audit, you can try and research. If a new quality improvement project will work in different settings, you can publish audits, you can publish quality improvement projects and you can also do quality improvement projects to improve how people do audits. So there are a lot of different um overlap between them, the audit cycle. Uh As we've kind of explained, you start with a question, you look at a standard someti sometimes you have to do a quick search to identify what standards are there. Excuse me. And if there isn't a clear standard, maybe experts in your hospital, like consultants can come up with a standard. You collect data, you analyze it and based on what you identify from the analysis, you can then say, well, if the issue was in, people didn't know, then you can try and do workshops. If people uh kept forgetting things, maybe you can have reminders. If people are very busy, maybe you can do automa automatic things. So really depending on the finding of your analysis, you don't, you don't implement change, you continue to implement change for some time. Uh And then you wait to see if that has had an effect. And the way that you know, you know that is you do the second cycle, you collect the data, you audit it and you see what's, what's going on. Um And you can see here it ends in implementing change. And then again, the idea is this continues, we're talking about an audit uh spiral here. Uh And the idea is we will continue to do this until we meet our standards, but even when we meet our standards, we, we still want to continue to just make sure that um we're continuing to adhere to, to the standard. So I'll send, um, um I'm just going to stop sharing very quickly now and I'll send a uh link with this handout. So this is a handout that I want you guys to uh quickly have a look at. It is a, an example of an audit that would be helpful if you guys could try and go through. All right. Um Do you guys, can you guys access this link? Yes, we can. So in this scenario, you are in fy two in an A&E you are assessing compliance to the nice guidelines regarding CT head scans with one within one hours for patients who have specified criteria. So nice guidelines have criteria for traumatic um head injury and for certain criteria, if you meet this criteria, then you have to have um a CT scan within ho one hour. And that, that CT scan is to be reported provisionally within another hour. Um And so all instructions are provided in the hands sheet. Um Initially, I thought I thought we could do the same group but just ignore that instruction. What we will do is you can try and do this individually, try and answer any like these questions. And afterwards, if anybody has any would like to share their answer, then they can turn on their microphone to, to answer that. What I will do is I will set five minutes uh and let you guys uh crack on with the questions, three minutes left, two more minutes. OK. Times up. Um Does anyone want to share some of their thoughts and, or their answers to the questions? Yes, I can share. Uh So the first question was, what information do you want to collect in order to assess local practice? Uh I think first I would uh like to assess the knowledge of er doctor of the criteria when to order a CT. So I think this is one of the things. Um Also, II think I need to go to the hospital records to check um You know, the, the CT S that are available if they're according to the guidelines. Yeah. Um Where can this information be found? Um It's more of, of emergency and radiology department. Um The challenges um you know, I'm, I'm applying this. If I wanna do this in my country, Sudan, I would think the challenges would be to have access to the hospital records. I see because yeah, the documentation is not that great, but um I cannot really relate to the NHS. What, what kind of challenges I might face there? That's fine. We'll talk, yeah, we'll talk a bit about what you could do within the, within, within an NHS environment. Thank you. Um Does anyone have anything to add? Ok, good. I could Um I'll just go back to sharing my screen. Uh Can you guys see the screen now? Yeah, not yet. No, no. Mm oh there we go. OK. Yeah. What about now? Yeah we can see. OK, perfect. So uh really it's a good start is half the battle with an audit because with an audit you want to go through patients record, look at a lot of different information, collect as much data as possible. So before you start, it's really important that you identify what data you want to collect. And the reason why you want to identify this data is you don't wanna be halfway through the audit and realize you've missed critical information because they have to go back and redo it again and that takes a lot of uh time. So for each of one way you could go about it is you need to look at the targets that you want to meet. And then for each of these targets from your standard, you want to consider what information that you need to get that will allow you to understand the compliance of um of our current practice. And if possible, you want any information that would help you understand why there are gaps. So for example, Ella, you mentioned, you want to know if the doctors actually know of these nice guidelines. So that would be really important information to know in general because it would allow you to understand if there are gaps then because potentially they don't know. Um you also want to ident collect identifiers of patients. You want to get information about them, you want to be able to know their age, their gender, maybe their ethnicity. Because if you are doing a large audit, you want to see if there, if the findings vary based on these characteristics in one of the audits on that. We, the oral presentations, the presenter spoke about how a lot of the chest X ray should be pa but many of them were ap because a lot of them were in older patients who might be go down to the X ray in uh a bed. So collecting age information will allow it to be able to give us that insight. Uh Also what their complaint was, the time they were admitted, you want to also know the time that the data was collected and you wanted to be as concise as possible, but to cover as much of this information. So you don't want to collect data that are not necessarily important. Um And you want to make it easy. Some people use excel sheets, but I find using Google forms a lot easier because you keep everything in the same place if you're less likely to make mistakes and enter things in the wrong cell. Uh and you need to know the data sources for what you need to do that you need from where you need to get this information you could look at patients note if they're electronic or if they're paper forms, you also want to be able to access packs, which is quite universal. Actually, it's been, it's used in um different parts of the UK and across the world. Uh And that would allow to know when the scan happened, what kind of investigations were done. There are a lot of potential challenges that you can get, you can have really poor documentation. So you want to know for example, what time the risk factor was identified, but sometimes this is not really documented in emergency departments. Patients are sometimes seen by doctors clerked, uh had have their investigations done and then the doctors would document. So the the times of documentation might not be reflective of when the risk factor was identified. Um You, they sometimes doctors may not necessarily document all relevant information. Uh for example, if they spoke to the radiologist and had their CT scan vetted, they may not necessarily document that very clearly. Um And then a lot of these targets are quite aspirational. So 100% compliance, um a and a lot of times the standards are 100% and the reason they are 100% even though we know 100% is not always achievable is because we want to encourage people to continue to uh want to do best practice. The work is never done. So people want to, we want to encourage continuous improvement. We want to encourage doctors to problem solve. So if we're always finding that adherence is 85 85 85 then those who are doing the job would think about, oh, maybe we can change this, maybe we can change that. And again, it encourages accountability. And if you think about this, again, this is exactly what clinical governance is all about. We want to give our patients the best care and that's why our standards are 100%. They're very aspirational because we want to continue to aim for that 100%. So for the next uh exercise, you have had the results of this audit, you've got the data collected and then I want you to, to assess whether or not the audit criteria has been met. Again, I'll send uh I'll send uh another handout sheet and I want you to uh try and answer whether or not the criteria has been met and then the percentages uh and think about what reasons might have affected this. I know we don't have a lot of time with 10 minutes, but uh what I want you to try and get to it as much as, as, as much as through as much of it as you can. So I'll just stop sharing and then I'll send you guys the link. So let me know if you can access this. I'll set a timer for 10 minutes. Yes, we can. All right, perfect. So just try and go through as much of the, as much of the worksheet as you can. Ok. Five more minutes. Oh, I just noticed some people wanted chair access. Um, just because everybody's looking at the same one. If people can, like, all edit on it, it might be a bit confusing. That's why it's just few only, but maybe you can download it three minutes more. Ok. If, um, we've got about a minute left but if everybody's done, um maybe we can come back. Uh Do you guys want to share um the answers to the question in terms of whether the criteria was met? And if you have, if you've managed to calculate some of the percentages, uh should I answer yes, please. So according to me, uh for the first one, the criteria 60% method. Yeah, for the 2nd 1 70% and then for the third one, I believe that 100% of them clearly documented the indications. Ok. Um What about other people? Did everyone else get um the same percentages? I'm gonna share my screen. So in this situation, I'll let me share my actual um my answers. So in my situation, uh I have 123, I have 60% for the first one and then I also, I have 70% for the second one, but I have 70% for, I have 123, I have 70% for the second one. So it's a little bit different. Um It doesn't mean that this is the correct one with these types of audits. Uh Let me just where is my thingy again? Um Differences are expected and the reason why differences are expected is because different people interpret things differently. So if we go back to this one, for example, here, um I marked this as no, because I thought in this situation, the patient has headache. Uh And then the CT is to rule out an intracranial pathology, but they don't necessarily specify why. But in the guidance, it says that the if there is suspicion. So where is it? Um the following criteria, if there is a suspicion of an injury, so that you could interpret that as meeting the criteria, you could also interpret it as not. For example, here, this patient had an epileptic seizure and ha and now have a new focal neurology. Someone could interpret this new focal neurology as um as a, as a post ectal state. So it might not be clearly communicated that this new new foc focal neurology is because of the um head injury. And again, here there is a, we want to see if there's a bleed or a skull fracture. So this might not be very clear that we're talking about these criteria. So when different people do uh different cycles of the audit, for example, it's difficult to interpret the results that there's actually improvement because different people might interpret it differently. Uh And even looking the same information, people could have very different um uh outcomes. And that's why when people are doing really large audits like multiside audits, you would want to have clear standard for what is accepted and what's not accepted. And uh tiebreakers if people are not very clear, um when you're looking at these, um, if we go back to this, when we're looking at these differences, so we said here, there are 60% there are 70% and I'm just going with what you mentioned 100% which uh again, we would expect there to be some differences when you're working in a clinical environment. And when you're doing an audit about your own practice, you would have a lot of clear insight as to why this is the case. So when we're looking at situations where the target were not met, sometimes it could be at specific times. So this might be the time when the porters go for lunch. So there may not be, there might be delays there. It might be around handover time. That's why people are not getting to the scanner in time. This is the morning handover, this is the afternoon handover. So maybe that's why also, if it's out of hours, there might be some delays. Uh And that's why when you're working, you're able to really tell um you're able to really identify the issues and when you're coming out with interventions in a lot of times people say, well, we would do teaching sessions. But this is the, the more insights you have from the data, the better uh um interventions that so that you will have. So instead of saying, well, we would want to do this as a teaching session for in A&E department, you can say, well, we would want to do this as reminders during handovers that people should do X and Y because that's the time where a lot of people have the the most difficulties or when we're not really meeting our target. So the more information you have, the more insight, the better interventions that you'll be able to have. And this is basically the exercises that we've done. This is, this would be considered if you've managed to continue to do this, the, the from the beginning to the end, identify the data, selected, analyze it. What we've done today is quite sufficient for you to do to have a good quality audit that you could submit in conferences. Uh I'll send, um I'll just send here what the audit, what this abstract is like if people want to, I have a look. So this is not the abstract. This is a for the uh this is for the post questionnaire, but let me just share the abstract with everybody. Uh So they can go through it in details if you want to, you can copy it or anything. Um Basically, we're, when you're trying to write it down. What you have to do is I'm going to quickly go through it, but you have it so that you can go through it in detail. Uh Basically in your introduction, you want to clearly say that you've audited something and you want to mention what the standard was in your method. You want to explain the data that you've collected, but make sure you clearly mention your targets because that's what people are able to uh assess your results on in your results. Make sure you write numbers and percentages. It's not sufficient to say the majority of patients were this or the majority met the target, you need to clearly specify these targets. Um And then once you've done that you need to add the insight that you got from this analysis. So in our situation, for example, we noted delays in scans performance are reported when it was staff break times when it was shift handovers when the reporting did not necessarily include clear guidance. And the why the reason why you want to mention these insights is because you also want to then say included in your conclusion. So in your conclusion, you want to have very specific information. So here, uh for example, you want to streamline the scanning process. So if you find that many people don't mention the indication, you can have a specific CT head request for trauma. And you have to for example, take what indication it is or what spec suspicion it is and you don't need to mention anything else. Uh You can also include staffing during uh peak hours or break times. People can maybe should not go on break all at the same time. Uh You want to enhance the communication between A&E and the department so that when there is a clear way of saying, oh, this is a one hour pathway. Um So you want to make sure that your intervention are very specific and this way you would have um kind of completed an, an the audit. So I want you to fill in this questionnaire and this is the last activity that we will do. So it is this link here. I'll send it again and once you do so I will just wrap up, we have four extra minutes. So I'll give you one minute to finish this and then we'll come back. Um I had a question. Sorry. Did you say you have a question? Yes. Oh OK. Will take questions in a minute or less. OK. All right. So I'm just going to share my screen now and we'll wrap up so that we can go back to the general um session. Sorry. No, there's a question. Yeah. Yes. So I wanted to ask, for example, if I want to do an audit. Yeah, but there is not a known guideline that I would follow. But I sit for example, with a bunch of radiologists and we set a common standard and then we compare it to those. Is it still considered a noted or does it need to be uh recognize guideline? No, that that would still be an audit. So um the standard either comes from research which would be high quality evidence, but consensus or expert consensus is still considered a good evidence to set a standard. Um You can start with that and if you're planning on publishing that or getting that submitting that as an abstract, just in your methods, you need to say that your standard was set ba based on expert consensus. Um And this is the standard, you need to make the standard very clear. Uh But that should be OK because there, there's a lot of things in our day to day that you wouldn't necessarily have uh a clear standard for that doesn't mean you shouldn't try and find similar standards and then say expert consensus. And we, it was similar to this other um standard. Uh Hi Kenny, I see you there. We're just about to wrap up. Uh So I'll just share one last thing and then that should be the end of the workshop unless there are other questions. So the last thing is we talked about audits, but I mentioned that this was also about quality improvement projects. And like I said in earlier that a quality improvement project can use to, can be used to improve the conduct of an audit. Um So this workshop would be considered a quality improvement project. Um And the idea is we, we are creating this workshop to for doctors who to improve their knowledge and skills in conducting audits and quality improvements for the NHS. And like I mentioned, the quality improvement cycle is a plan do study and act. And in this situation, the plan here is us planning the workshop. The do is us doing the workshop at the moment and to assess the impact of the study is the pre and post uh questionnaires that you've done. And based on that, we will see if the the answers showed any improvement and that helps us um see if there's been an improvement or not. And if there is an improvement that you, we want to continue to do this and we want to refine it. So that's a big difference between what a quality improvement project is and what an audit is with an audit, you start the standard, but with a quality improvement project, you start with an intervention. And in this situation, like we talked through the abstract for an audit. This would what an abstract would be for this quality improvement project. It would be about enhancing doctors uh skills and knowledge in uh in, in doing clinical audits. Um And I'll send this as well quickly uh this information uh and that should be it for the audit. Obviously the result and conclusion part is uh empty because it would require you to do to us to doses of the um findings. But that, that is all. Thank you very much. All right. Um It's um let me just before you go. So I've just posted the whatsapp group. So anyone who sort of like miss the documents, who can post it to the research group on the whatsapp um research group. So sorry to do what the research, what I I've posted the link to the whatsapp Research group. So anybody who has any outstanding question can ask on the page? Ok, perfect. Thank you so much. Thank you. All right, bye. So, uh um can we all go back to um the main stage um the um next sessions about stuff? Thank you very much. Yeah. Thank you. Bye. Thank you. No. Yeah, bye.