Frequently asked questions for Professionals

The National Audit of Headache Disorder (NAHD) is a clinical audit to evaluate the quality of care provided to adult headache patients across UK. A key aspect of the Audit is to describe patterns of care across UK. The NHAD started in October 2024. The first programme of the NAHD is the National Migraine Audit which aims to evaluate the quality of care provided to adult migraine patients across UK.

The National Audit of Headache Disorders (NAHD) and its constituent workstreams, including the National Migraine Audit and Registry, are funded through foundraising and academic resources provided by King’s College London (KCL). To support the robust development of the audit’s digital infrastructure and data platforms, KCL has also secured collaborative grants from AbbVie and Pfizer. These partnerships enable the development of the "MyHeadache" and "HealthMachine" tools while ensuring the audit remains an independent, clinician-led initiative under the governance of the Steering Committee.

The National Audit of Headache Disorders (NAHD) is a national clinical audit governed by a multi-disciplinary Steering Committee, which provides strategic oversight and ensures the audit meets its clinical and quality improvement objectives. The audit and its workstreams are hosted by King’s College London (KCL). Operational management and day-to-day administration are conducted by the Headache Research Team within the Wolfson Sensory, Pain and Regeneration Centre at KCL. To support technical delivery, King’s College London maintains a formal service contract with Avegen Ltd, who serve as the designated Data Processor for the audit's digital platforms.

The primary objective of the National Audit of Headache Disorders (NAHD) is to facilitate the improvement of primary and secondary care services for patients across the UK. National research and clinical data have consistently highlighted unwarranted variations in the quality and accessibility of headache care depending on geographic location. The NAHD aims to identify these disparities and understand the underlying factors driving them. By benchmarking current service delivery against national standards, the audit provides a clear evidence base for change. Our findings are shared with individual NHS Trusts, Integrated Care Boards (ICBs), and national policy makers to: • Target Improvement: Highlight specific service gaps and provide actionable data to support local and national quality improvement initiatives. • Inform Policy: Ensure that future healthcare planning is informed by real-world data from both clinicians and patients. • Celebrate Excellence: Identify and share examples of clinical best practice.

The inaugural workstream of the programme is the National Migraine Audit and Registry. Participation is open to the following groups: • Healthcare Providers: Any NHS healthcare professional or provider involved in the management of migraine patients can register (both in primary and secondary care). By particiopating to the Audit, clinicians invite their patients to use the “MyHeadache”App of the Audit. They can also gain access to the HealthMachine platform, which allows them to visualize real-time e-diary data from their own patients (if the patient agreed to share their data with the clinician), facilitating better clinical monitoring and local service evaluation. • Patients: All adult patients who have received a clinical diagnosis of migraine at an NHS facility within England, Wales, Scotland, or Northern Ireland are eligible to participate.

The National Migraine Audit and Registry utilises two primary data streams to ensure a comprehensive evaluation of migraine care: 1. Direct Patient Input (Prospective Data): Data is collected directly from patients who provide explicit consent to participate via the 'MyHeadache' e-Diary app. This includes the integrated History Tool, which captures the patient pathway through diagnostic and treatment background, and the daily e-diary, which tracks real-time symptoms and current care. 2. Clinical Database Integration (Retrospective Data): To provide a broader national perspective, the audit also utilizes pseudonymized, aggregated healthcare data from the Clinical Practice Research Datalink (CPRD), specifically the GOLD and Aurum databases. This allows the audit to analyse longitudinal trends in primary care. More information on how we manage data can be found in our privacy policy.(https://www.headacheaudit.org.uk/resources) How King’s College London manages data can be found here K(https://www.kcl.ac.uk/research/research-environment/rgei/research-ethics/use-of-personal-data-in-research#:~:text=Under%20UK%20data%20protection%20law,the%20Principal%20Investigator%20takes%20responsibility.)ing’s College London Statement on Use of Personal Data in Research.(https://www.kcl.ac.uk/research/research-environment/rgei/research-ethics/use-of-personal-data-in-research#:~:text=Under%20UK%20data%20protection%20law,the%20Principal%20Investigator%20takes%20responsibility.)

The national data opt-out allows patients to opt-out of their information being used for purposes other than their immediate clinical care (such as for audit and research purposes). All NHS organisations are required to be compliant with the national data opt-out policy. For more information on the national data opt-out, please visit the NHS website: https://www.nhs.uk/your-nhs-data-matters/(https://www.nhs.uk/your-nhs-data-matters/) For national clinical audits such as the National Audit for Migraine and Registry, where patient reported outcomes are collected, patients are given the opportunity to consent for their data to be used for the purposes of the National Audit for Migraine and Registry. Their rights, and how to opt-out can be found in our privacy policy. For more information see the privacy policy.(https://www.headacheaudit.org.uk/resources)

The National Migraine Audit collects comprehensive data submitted via the 'MyHeadache' app from individuals (age 16+) diagnosed with and treated for migraine within the UK. To evaluate care quality effectively, the audit captures amongst others the following data points: Clinical & Diagnostic Background • Clinical Setting: Details regarding whether the patient is receiving care in primary care (GP) or secondary/tertiary care (Specialist/Neurology). • Diagnosis & Investigations: Information on the type of migraine diagnosis and any previous clinical investigations (e.g., neuroimaging). • Treatment History: A record of past acute and preventative treatments to understand the patient's journey before their current regimen. Current Management & Safety • Active Treatments: Real-time data on current prescriptions and acute medication usage. • Adverse Events: Patient-reported side effects or complications arising from current treatments, which is critical for assessing the safety and tolerability of newer therapies. Quality of Life & Impact Measures • Validated questionnaire outcomes used to measure the functional impact of migraines on daily life. • Healthcare Utilisation: Frequency of A&E or urgent care visits specifically due to migraine attacks. • Socioeconomic Impact: Data on work absenteeism and productivity loss (presenteeism) to quantify the broader economic burden of the condition. The Audit also captures data from CPRD, that include amongst others, migraine insistence, acute and preventive prescriptions and referrals to secondary care.

All NHS healthcare providers are expected to participate in national clinical audits relevant to the services they provide. Participation is a key requirement of the NHS Standard Contract and is essential for demonstrating high-quality, evidence-based care. The National Audit of Headache Disorders (NAHD) and its inaugural workstream, the National Migraine Audit, are formally listed in the Healthcare Quality Improvement Partnership (HQIP)(https://www.hqip.org.uk/) Directory. Participation not only fulfills national reporting expectations but also provides local clinical leads with the data required for Service Evaluation and Quality Improvement (QI) initiatives within their departments.

Yes, if you are Trust participates in the Audit, please contact us and we can provide you with relevant number of cases. If you are a registered healthcare professional for the audit, the most direct way to see your submission data is via the HealthMachine platform. The platform provides a visualization of data submitted by patients who are linked to your specific NHS Trust or clinic. Within the dashboard, you can typically filter by date range (e.g., January 2025 – December 2025) to see the total number of active e-diaries and history tool completions. If you are a GP practise, participating via the CPRD, we will not be able to provide you with inidividual cases. However, you can still participate in the Audit by registering via the HCPs registration (https://www.headacheaudit.org.uk/hcp-portal)portal in the NADH website and by asking your patients to use the "MyHeadache" mobile application of the Audit.

For all queries related to the NADH, please contact us.(migraineaudit@kcl.ac.uk)

To facilitate a local audit, please provide us with formal confirmation of your project’s registration with your Trust’s Clinical Audit or Effectiveness Department. Once verified, we can enable the necessary permissions within the HealthMachine portal to allow you to export your organisation’s pseudonymized, aggregated data in a spreadsheet (CSV) format. This will enable you to perform local analysis and benchmark your service against national standards.