Trusts need to overcome public scepticism about quality accounts by being honest about their standards and embracing patients’ priorities, research from the King’s Fund says.
Interviews with members of NHS involvement groups showed patients generally lacked trust in the accounts, which all acute providers have to publish for the first time this year.
I actually doubt [trusts’] ability to be self-critical
Members of the public questioned whether accounts would give a “full and accurate picture of performance” and would leave out areas of poor performance, the think tank’s report Accounting for Quality to the Local Community says.
One interviewee told the researchers: “I actually doubt [trusts’] ability to be self-critical… they’ll sing their praises and obscure their faults.”
The report by senior policy fellow Catherine Foot and researcher Shilpa Ross says: “Our participants felt that it was likely that quality accounts would resemble public relations brochures rather than honest ‘warts and all’ evidence.”
Doubts over the frankness of quality accounts could undermine the initiative, which was recommended by the final report of Lord Darzi’s next stage review and was intended to make trusts more accountable to the public.
To overcome this, the King’s Fund says trusts should seek involvement in producing the accounts from patient and public groups as early as possible.
It says trusts should base the indicators they include on public priorities and give data to patient groups throughout the year, so the groups can judge quality for themselves.
Trusts should include indicators that accurately and fairly represent the overall quality of services and work with their quality observatory to make sure data quality is good and they have “robust and comparable” indicators.
The Department of Health has decided to require independent assurance only from trusts’ commissioners in the first year of the accounts, although Monitor has said foundation trusts’ accounts must be externally audited. The DH is also allowing free choice of which indicators to include.
This, the report says, means trusts will “need to work harder to ensure and demonstrate that their data is robust, fair and representative”.