Hospitals' quality accounts pass first test
Richard Johnstone | 5 January 2012
NHS trusts have made a ‘strong start’ to the production of annual quality
accounts, but need to link the process to their wider improvement work,
auditors have concluded.
The 2009 Health Act requires providers of NHS services to produce
an annual report to the public on the quality of their services. Primary care
trusts and community trusts are exempt.
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
‘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.’