Quality accounts provide the basis for NHS providers to begin to provide consistent public information about the quality of their services, and can help to foster accountability.
Some of the content of quality accounts is determined by the Department of Health, but it can also include information that reflects local priorities. There is an important balance to be struck between reporting on nationally, comparable quality indicators and measuring and reporting on what matters to local people and stakeholders.
Mandated national indicators will allow comparison between providers and provide assurance that the organisation is performing to required standards, such as the Care Quality Commission’s essential standards of quality and safety. Locally-determined measures should ideally be based on indicators for quality improvement and can help to reflect progress on local improvement priorties.
The NHS Confederation supports the focus on strengthening public reporting of information on quality, but we are concerned to avoid the duplication of reporting requirements. Indeed the development of mandated content for quality accounts may raise questions about the continued need for some centrally collected data returns.
It is essential that any measures that are included in quality accounts must be robust and valid, and should illustrate how performance compares with other providers or nationally, and whether it has changed over time.
We believe that it is vital to allow sufficient local discretion in developing quality accounts to foster innovation in quality reporting.
Participation in clinical audit
NHS Trusts in England are required to report on their participation in national clinical audits as part of their Quality Accounts. Provider boards must report on which audits they participate in and their level of participation. They should also report on what they have done in response to the findings. This is intended to encourage trusts to participate in and use national audit findings to improve the quality of their care. The public discussion of their participation in clinical audits and their use can help to reassure patients and the public that the issues covered are taken seriously.
Providers are already required to report on their participation in certain clinical audits in their quality accounts. More information about the current range of clinical audits is provided by the Healthcare Quality Improvement Partnership (HQIP).