Recommendation 37

Trust compliance with standards in quality accounts

Trust Boards should provide, through quality accounts, and in nationally consistent format, full and accurate information about their compliance with each standard which applies to them. To the extent that it is not practical in a written report to set out detail, this should be made available via each trust’s website. Reports should no longer be confined to reports on achievements as opposed to a fair representation of areas where compliance has not been achieved. A full account should be given of the methods used to obtain the information. To make or be party to a wilfully or recklessly false statement as to compliance with safety or essential standards in the required quality account should be made a criminal offence.

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 information that must be included within part 2 of the quality accounts to ensure they are comparable, including information on their compliance (see recommendation 246).

The quality accounts are published nationally via the NHS Choices website to ensure that they are accessible and the information they contain on quality is available to patients and the public (see recommendation 247).

The government agrees that reports should not be confined to achievements, and should reflect a balanced view of quality.

Professor Sir Bruce Keogh’s report Review into the quality of care and treatment provided by 14 hospital trusts in England stated as an ambition that ‘patients and the public, will have rapid access to accurate, insightful and easy to use data about quality at service line level’. This includes an action that the ‘the requirements for quality accounts for the 2014-15 round begin to provide a more comprehensive and balanced assessment of quality.’

NHS England 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.

The review will consider recommendations 246 to 251 concerning the quality accounts, along with the action highlighted in Sir Bruce’s report, and will report in early 2014. It is expected that the review will be complete so that guidance can be issued in March 2014 and trusts advised of expected changes in early 2014.


A review of Quality Accounts has taken place and engaged 180 stakeholders, including patients, carers, and service providers, Healthwatch, NHS England, NHS Trust Development Authority and Monitor. The Quality Accounts Stakeholder Group has updated the purpose of Quality Accounts; ‘Quality Accounts should give the reader the confidence the organisation was being open and honest about the quality of services being provided and was committed to driving continuous quality improvement’. Following this review a Quality Accounts Data Dictionary was developed and published in March 2014 to improve the consistency of indicator data and definitions. A live set of frequently asked questions has also been published in March 2014 focusing on specific areas of quality account production, including further technical guidance relating to indicators and information about who has to produce a quality account. Both of these are hosted on NHS Choices and can be updated throughout the year. Organisations take their indicator reporting information from the Health and Social Care Information Centre Quality Accounts Portal for purposes of consistency and accuracy. The Health and Social Care Information Centre portal was refreshed in March 2014.