Recommendation 142

Unambiguous referral and information

For an organisation to be effective in performance management, there must exist unambiguous lines of referral and information flows, so that the performance manager is not in ignorance of the reality.

The reformed NHS system includes a number of different lines of accountability, so it is crucial that there is no ambiguity or confusion about these accountabilities or about the information flows which inform them.

Providers are accountable to their commissioners for the quality of services they deliver. The NHS Standard Contract provides for clarity on information flows between provider and commissioner.

In primary care, the introduction of the General Practice Extraction Service and Calculating Quality Reporting Service ensures that clear and accurate performance management information is provided within services commissioned from GP contractors.

NHS trusts are also accountable to the NHS Trust Development Authority for their overall performance, including for providing high quality services. The accountability arrangements for NHS trusts are set out in Delivering High Quality Care for Patients: The Accountability Framework for NHS Trusts. The Accountability Framework is aligned with the standards set by Monitor and the Care Quality Commission, and the Trust Development Authority continues to work with its partners to ensure that it reflects any relevant changes, such as the Care Quality Commission’s new regime for the monitoring, inspection and rating of healthcare providers.

NHS England and the NHS Trust Development Authority have agreed protocols to ensure that there is no uncertainty or duplication in processes for intervening in local health communities where there are concerns about quality or safety.

No update required. Please see response to the recommendation above