Use of information about compliance by regulator from: Quality accounts

Accepted.
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).
We also agree 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 (NHS England, July 2013) 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 such that guidance can be issued in March 2014 and trusts advised of expected changes in early 2014.

In response to this recommendation a new offence was created which is set out at section 92 of the Care Act 2014. The offence is applicable to care providers who supply, publish or otherwise make available certain types of information that is false or misleading, where that information is required to comply with a statutory or other legal obligation. The offence also applies to directors, managers, secretaries of similar officers of care providers, where they have consented or connived in an offence committed by a care provider. A defence is available where a care provider can prove it took all reasonable steps and exercised all due diligence to prevent the provision of false or misleading information.

As described in our response to recommendation 17 above, NHS Trusts are required to publish Quality Accounts annually and share with the local Healthwatch.

The CQC and NHS England have power to require corrections or errors and omissions in these reports.

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.

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government agreed that reports should not be confined to achievements and should reflect a balanced view of quality.

In the February 2015 Culture Change report, the Government said that a review of Quality Accounts had taken place, with 180 stakeholders being involved. The Government said that, as a result of the review, the purpose of Quality Accounts had been updated to reflect the need for openness and honesty and a Quality Accounts Data Dictionary was developed and published in March 2014 to improve the consistency of indicator data and definitions.

Current NHS guidance requires every quality account to have a signed statement from the most senior manager of the organisation, declaring they are happy with its accuracy and are aware of the quality of the NHS services provided.