Quality assurance procedures are essential in the maintenance of clinical standards in medicine. Conventional analysis techniques have difficulty in detecting gradual changes over time. Cumulative sum techniques monitor the frequency with which an event occurs and can detect changes in its frequency as soon as they become statistically significant. This study explores the use of cumulative sum techniques to monitor the performance of an acute pain team in a teaching hospital. It shows that periods of suboptimal performance can be readily identified. The prospective use of these techniques in clinical audit may allow the earlier identification and correction of technical or organisational problems. These should lead to improvements in patient care and satisfaction.