Accountability for quality accounts
Mid Staffs Inquiry · Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry · Issued 6 February 2013 · Addressed to: Healthcare providers
Government responseDepartment of Health and Social Care: Accepted in part (Nov 2013)
DeliveryDHSC and NHS England state no delivery position (Feb 2026)Department of Health and Social Care says in progress (Feb 2015)
Recommendation, verbatim from the inquiry
●Inquiry recommendation
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.
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 from September 2024 published in February 2026, the Department of Health and Social Care and NHS England marked the recommendation as superseded, stating that although it was accepted in part, the government later concluded that accountability was better served by enabling Healthwatch to challenge quality accounts locally (DHSC and NHS England, Feb 2026). In May 2024, the Thirlwall Inquiry legal team noted that the government had only partially accepted the proposal because existing regulations required an authorised statement on behalf of the provider rather than separate signatures from every director (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026.
About this summary
Report-level response context
Government response
●Department of Health and Social Care · Accepted in part · 19 Nov 2013
Accepted in part.
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 (Monitor, March 2013) 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 Quality 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 (Department of Health, April 2012) 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.
Delivery
●DHSC and NHS England state no delivery position · 27 Feb 2026
This recommendation was accepted only in part.
The recommendation was implemented at the time, but the Government subsequently set out that the review of quality accounts had considered this recommendation, and felt its aims could be better achieved by enabling Healthwatch to challenge quality accounts locally.
●Department of Health and Social Care says in progress · 11 Feb 2015
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.
What other bodies have found
●Thirlwall Inquiry legal team · 15 May 2024
This recommendation was accepted in part by the Government.
In the January 2014 Hard Truths report, the Government said that the National Health Service (Quality Accounts Regulations) 2010 required quality accounts to include a written statement signed by the responsible person for the provider that to the best of their knowledge the information in the document is accurate. They did not have to include a separate signature from each director.
In the February 2015 Culture Change report, the Government said the review of quality accounts had considered this recommendation, and felt its aims could be better achieved by enabling Healthwatch to challenge quality accounts locally.
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.