Missing detail renders NHS quality accounts ‘meaningless’

Last month all hospital and mental health trusts had to publish their first quality accounts - invented by the last government and intended to be “reports to the public on the quality of services they provide in every service line”.

People expect to be given information to make decisions and they will be able to see through this

HSJ looked at the accounts of 50 randomly selected hospital trusts and found many had left out elements which have been identified as vital if they are to improve public accountability.

Nearly one in four in the sample (12 trusts) did not include any indicators at all in the section of the accounts where they were meant to review the quality of their services. In many cases they instead commented on quality related work they had done or planned to do.

Nearly half (21) did not include any measures of performance against previous years, meaning readers could not tell if services had improved or worsened. Just one in 10 (five) included average national scores, or those of comparable trusts to enable the public to use comparisons when making choices about their care.

Sixteen trusts - nearly a third of those in the sample - had not included an indicator with one or more of their quality improvement priorities, making it difficult for readers to check if they are achieved.

In some areas trusts have performed better, for example 60 per cent (30) included a response to the account from their local involvement network.

When quality accounts were announced public and patient representatives said they were concerned they would be a “paper exercise”. Some, including consumer charity Which?, called for a small set of measures and benchmarking to be compulsory

Which? senior public affairs officer Paula Pohja said: “Unless trusts include comparable benchmarks this is a PR exercise.

“People expect to be given information to make decisions and they will be able to see through this.

“Quality accounts could be a great way of helping patients but unless they can compare trusts it becomes meaningless and potentially misleading.”

A DH spokeswoman said: “This first set of published quality accounts shows a wide variety of approaches within the statutory framework, as each provider has worked with its own staff, patients and public groups to arrive at an agreed account of care quality and priorities for improvement.

“HSJ’s figures show that 60 per cent of LINks provided a response, which demonstrates their interest in quality accounts as a mechanism for fostering local accountability.

“This first year of publication shows great promise, and will provide valuable lessons for the future development of quality accounts.