Recommendation 249

Quality accounts certified by trust directors

Accepted in part
Each quality account should be accompanied by a declaration signed by all directors in office at the date of the account certifying that they believe the contents of the account to be true, or alternatively a statement of explanation as to the reason any such director is unable or has refused to sign such a declaration.

The National Health Service (Quality Accounts Regulations) 2010 state that quality accounts must include a ‘…written statement… signed by the responsible person for the provider that to the best of that person’s knowledge the information in the document is accurate…’  While this does not include a separate signature from each director, the quality account is signed as an accurate and reliable record on their behalf.

2012/13 Detailed Guidance for External Assurance on Quality Reports states that for 2012/13 foundation trusts will be required to sign a statement of directors’ responsibilities in respect to the quality report that states that performance information reported in the auality report is reliable and accurate.  This is signed by order of the board by the chairman and the chief executive.

Quality Accounts: 2011/12 audit guidance states that trusts must sign a statement of Directors’ responsibilities in respect of the content of their quality accounts.  This includes a statement that, ‘…the performance information in the Quality Account is reliable and accurate’.  This is signed by order of the board by the chairman and the chief executive.

We will review quality accounts before the 2014/15 cycle to ensure that they give patients appropriate information regarding the services they use, and that they add value to the quality assurance infrastructure used by trusts, local and national organisations.  While the review is yet to complete, we anticipate that NHS England will implement this recommendation and include it within guidance that it intends to issue by the end of March 2014.  NHS England will advise Trusts of expected changes in early 2014 to support them to plan for the 2014/15 cycle.


The review of Quality Accounts has considered this recommendation. The review felt strongly about accountability and was clear that this could be better achieved by enabling Healthwatch to challenge Quality Accounts locally, given the existing requirements set out above. We will work with Healthwatch to develop guidance. We also intend for Quality Accounts to fall within the scope of the ‘false and misleading information offence’ and for the offence to apply for them. This should come into effect by winter 2014.

The review also felt it was important for Quality Accounts to be made accessible to the public in a more patient friendly format. NHS England plan to issue guidance to support this in 2014/15.