F246

Comparable quality accounts

Mid Staffs Inquiry · Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · Issued 6 February 2013 · Addressed to: Department of Health and Social Care

Government responseDepartment of Health and Social Care: Accepted (Nov 2013)

DeliveryDHSC and NHS England say in progress (Feb 2026)Department of Health and Social Care says in progress (Feb 2015)

Recommendation, verbatim from the inquiry

●Inquiry recommendation

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.

Mid Staffs Inquiry, Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · 6 Feb 2013 Source PDF →

Published evidence summary

AI-generated evidence summary

In commentary submitted in September 2024, the Department of Health and Social Care and NHS England stated that eligible NHS healthcare providers are required by regulations to publish annual Quality Accounts, citing guidance on reporting clinical audit participation and related improvements (DHSC and NHS England, Feb 2026). In a review published in February 2026, the Thirlwall Inquiry legal team found that while regulations prescribe certain details, there was no reference to this including information about compliance with fundamental standards or proposals to rectify non-compliance (The Thirlwall Inquiry legal team, Feb 2026).

AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026.

Report-level response context

Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.

Government response

●Department of Health and Social Care · Accepted · 19 Nov 2013

Speaker not recorded. Source: Department of Health, Hard Truths: the Journey to Putting Patients First, volume 2 (Cm 8777-II), November 2013

Accepted.
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; and
• 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.

Response document: Hard Truths: The Journey to Putting Patients First. Volume Two of the Government Response to the Mid Staffordshire NHS Foundation Trust Public Inquiry: Response to the Inquiry's Recommendations

Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.

Delivery

●DHSC and NHS England say in progress · 27 Feb 2026

NHS healthcare providers are required under sections 8-10 of the Health Act 2009 and in the terms set out in the National Health Service (Quality Accounts) Regulations 2010 (as amended by SI 2011/269 and 2012/3081)to publish Quality Accounts (annual reports on the quality of their services) if they deliver services under an NHS Standard Contract, have staff numbers over 50 and NHS income greater than £130k per annum.

Guidance published by the Healthcare Quality Improvement Partnership notes the requirements for Quality Accounts to contain details of the trust’s clinical audit participation for each of the national audits, enquiries and quality improvement programmes they participate in, along with information related to improvements responding to clinical audit report recommendations

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025)

Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented - Ongoing”. Table row: section 18.2 No. 246, PDF page 556.

●Department of Health and Social Care says in progress · 11 Feb 2015

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

From: Culture Change in the NHS supporting Annex (annex to Culture change in the NHS: applying the lessons of the Francis Inquiries)

Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.

What other bodies have found

In their own words. These do not change the delivery statement above.

●Thirlwall Inquiry legal team · 27 Feb 2026

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government referred to the National Health Service (Quality Accounts Regulations) 2010, the National Health Service (Quality Accounts) Amendment Regulations 22011 and the National Health Service (Quality Accounts) Amendment Regulations 2012 as setting out the prescribed information which must be included in Quality Accounts. This included the value and banding of the summary hospital level mortality indicator and statements of the overview scrutiny committees, relevant CCG or NHS England, and the Local Healthwatch.

However, there was no reference to this including information about compliance with the fundamental and other standards or proposals for rectification of non-compliance.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025)

Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 18.2 No. 246, PDF page 556.

Earlier findings (1)

●Thirlwall Inquiry legal team · 15 May 2024

This recommendation was accepted by the Government.

In the January 2014 Hard Truths report, the Government referred to the National Health Service (Quality Accounts Regulations) 2010, the National Health Service (Quality Accounts) Amendment Regulations 22011 and the National Health Service (Quality Accounts) Amendment Regulations 2012 as setting out the prescribed information which must be included in Quality Accounts. This included the value and banding of the summary hospital level mortality indicator and statements of the overview scrutiny committees, relevant clinical commissioning group or NHS England, and the Local Healthwatch.

However, there was no reference to this including information about compliance with the fundamental and other standards or proposals for rectification of non-compliance.

From: The Thirlwall Inquiry: Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024)

Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 246, PDF page 512.

How this page is built

The recommendation and the government responses are verbatim from primary documents. Delivery statements and other bodies' findings are shown in their own words, each with its source. The summary is written by this site and labelled as such. The Index does not paraphrase sources or characterise intent; it records what has been published.