The Audit Commission examined the 2010/11 quality accounts produced by 91 NHS acute and mental health trusts and 52 foundation trusts.

This was the first year acute and mental health trusts were required to produce quality accounts and acted as a ‘dry run’ exercise. The commission found that 96% of the trusts had acceptable arrangements in place to assure themselves their quality accounts were fairly stated and 95% complied with Department of Health requirements. From 2011/12, these trusts’ quality accounts will be subject to an auditor’s opinion.

Foundation trusts had their dry run the previous year, and their 2010/11 accounts were audited. All 52 accounts were approved by the auditors.

But all trusts need to address aspects of production, the commission said. ‘In particular, they need to embed producing quality accounts into trusts’ wider quality improvement agenda, rather than treating them as a standalone exercise,’ its report stated.

Many trusts had also failed to involve patients, staff, commissioners and local improvement networks sufficiently in the production of the quality accounts. Trusts should ‘engage more fully’ with these stakeholders, the commission said.

Commenting on the report, Catherine Foot, a senior fellow at health think-tank the King’s Fund, said NHS organisations were still ‘developing their ability to produce these reports’.

She said: ‘It’s good that the Audit Commission has picked up on the [need for] local involvement, as these are local reports.

‘As trusts get to choose what indicators they use, they are local documents that set out the local organisation improvement priorities. So it’s really fundamental that they have input from the local network and the new Health and Wellbeing Boards and other local groups.’

A Department of Health spokesman said that quality accounts were ‘an invaluable tool for the NHS to assess the quality of all the health care services they provide to patients’.

He added: ‘We are pleased that the Audit Commission report has found overall improvement, but we know more work needs to be done in some areas.

‘We are taking the necessary action including looking at ways to increase the number of indicators that all trusts must concentrate on in their quality accounts.’

The body representing foundation trust said it was ‘pleasing’ that they had all received the assurance they needed on the content of the reports. Foundation Trust Network chief executive Sue Slipman added: ‘Quality accounts are in their infancy. All foundation trusts have shown that they can get the fundamentals right when reporting on quality, and many foundation trusts, including those highlighted in the report, are excelling.

‘There is no doubt that with the basics in place on reporting that more and more trusts will grasp the opportunity to integrate the accounts into their overall quality improvement processes and to ensure these are properly owned by boards.’