The NHS has made only limited progress in improving its data quality in the last five years, the Audit Commission has said.

In a report published this week, the commission warns much NHS data is “virtually wholly reliant on internal assurance processes and self-review”.

The report follows revelations about health and social care bodies - including Mid Staffordshire foundation trust and Haringey council’s social services - which had self-declared themselves “compliant” with regulatory standards but were later found to be severely lacking.

The commission says such poor data quality risks undermining the impact of measuring clinical outcomes - a major theme in health minister Lord Darzi’s next stage review - and the move towards a more detailed and accurate tariff for use under payment by results.

It is calling for quality accounts to be given a similar level of external scrutiny as financial accounts, and for this to be incorporated into the regulation of NHS organisations.

Data challenge

A commission investigation into the ways NHS organisations check whether clinical and activity data is accurate found “very little evidence of board level discussion or challenge of data quality”. Where high level involvement did exist, “this was the exception rather than the rule”.

The report draws comparisons with financial information and accounts that are drawn up following UK and international standards, developed by professional bodies to prevent manipulation and deceit.

But the standards used by the Care Quality Commission do not include reference to data standards and organisations are not penalised for submitting poor quality data to the regulator.

“If published quality accounts and the quality metrics associated with them are to stand alongside financial accounts as key components of governance and accountability for NHS bodies, they should be subject to the same rigour in their preparation” the report says.

The commission argues that NHS quality accounts and metrics should be subject to internal and external review.

Audit Commission recommendations to improve NHS data:

  • Greater involvement of the NHS Information Centre, which could report on the quality of activity data submitted to it
  • Commissioners challenging hospitals on data quality - particularly around activity data that directly links to commissioner costs
  • Introduction of data quality standards into the Care Quality Commission’s regime

HSJ is holding a Quality Improvement online seminar on 14 May, www.hsj-qualityimprovement.com