In 1993 he became the Clinical Audit Co-ordinator for the Health Protection Agency, formerly the Public Health Laboratory Service. From there he moved to the Royal College of Pathologists where he ran the clinical audit unit, and he joined NHS Blood and Transplant in 2000. He is the Programme Manager for the National Comparative Audit of Blood Transfusion (NCABT) and has conducted national clinical audits since 1996. NCABT audits blood transfusion practice in all UK hospitals, in 7 European countries and in 8 hospitals in New Zealand. He recently obtained a postgraduate leadership qualification from the NHS Leadership Academy.