Recommendation 246

Consistent format of quality accounts

Department of Health/the NHS Commissioning Board/regulators should ensure that provider organisations publish in their annual quality accounts information in a common form to enable comparisons to be made between organisations, to include a minimum of prescribed information about their compliance with fundamental and other standards, their proposals for the rectification of any non-compliance and statistics on mortality and other outcomes. Quality accounts should be required to contain the observations of commissioners, overview and scrutiny committees, and Local Healthwatch.

While quality accounts provide information about local providers’ performance, and should be flexible enough to support reporting at that level, they should also contain key information, in a common form, that allows direct comparisons to be made.  This includes information on compliance with basic requirements and performance on key metrics including a set of outcome statistics.

The National Health Service (Quality Accounts Regulations) 2010, the National Health Service (Quality Accounts) Amendment Regulations 2011 and the National Health Service (Quality Accounts) Amendment Regulations 2012 set out prescribed information that must be included within Part 2 of the quality accounts.

This includes the following information:

  • where the provider is subject to periodic review by the Care Quality Commission including:
    – the date of the most recent review
    – the assessment made by the Care Quality Commission following the review
    – the action the provider intends to take to address the points made in that assessment by the Care Quality Commission
    – any progress the provider has made in taking the action identified in the point above prior to the end of the reporting period.
  • the value and banding of the summary hospital level mortality indicator, and
  • other outcome measures including C. difficile per 100,000 bed days and the percentage of patients admitted to hospital who were risk assessed for venous thromboembolism. In addition, NHS England will issue guidance in October 2013 to include the patient component of the friends and family test as part of these measures.

In addition, the National Health Service (Quality Accounts) Amendment Regulations 2012 require all quality accounts to include an annex that contains the statements of the:

  • overview and scrutiny committee or joint overview and scrutiny committee carrying out the functions of that overview and scrutiny committee
  • relevant clinical commissioning group or NHS England where 50% or more of the relevant health services that the provider directly provides or sub-contracts during the reporting period are under contracts or arrangements with NHS England, and
  • local Healthwatch organisation.


In response to the recommendation, there is now an area on NHS Choices providing presentational guidance. As part of the NHS England review of Quality Accounts (see Rec 37), it was recommended this should be further developed to include guidance about publishing data in a more patient friendly way. The Quality Accounts review has also identified the need to provide local Healthwatch organisations with guidance on how to effectively challenge local Quality Accounts. This is being taken forward by NHS England and Healthwatch with a view that this will help to inform Heathwatch comments on Quality Accounts in 2014/15