Government delays GP quality accounts

A Department of Health letter sent last week said GPs would only be “encouraged” to publish the documents, covering 2010-11, from June with it becoming a formal requirement the following year.

It said pilot schemes this year found GPs struggled with the accounts and needed help from primary care trusts and strategic health authorities. Both are now facing enormous job cuts before abolition.

Acute, mental health, learning disability and ambulance service trusts had to publish their first accounts in June this year, covering 2009-10.

The regulations, published in March, said it would be extended to GPs and community services next year, “subject to a testing and evaluation exercise”.

The letter, from NHS medical director Sir Bruce Keogh, says the requirement would come in for community providers.

However it says: “The primary care pilots found that although primary care providers produced quality accounts to a good standard, they needed much assistance from PCTs and SHAs.

“Further testing is therefore required, so we intend to encourage primary care organisations to produce quality accounts in June 2011… At present, the intention is to make quality accounts a formal requirement for primary care providers from the following year.”

The letter says providers in the pilot found it “useful” and accounts were produced “to a good standard”. However it adds “many struggled with the initial production, needing much assistance from PCTs and SHAs [primary care trusts and strategic health authorities]”.

King’s Fund fellow Catherine Foot, co-author of a forthcoming report on quality accounts, said it was sensible to get regulations right before telling GPs to publish. But she said: “In terms of the proportion of patient contacts accounted for by primary care, it is incredibly important for us to understand better the quality of services. That is hugely important.”

Meanwhile, the letter said requirements for other providers’ accounts next year would be largely unchanged, despite finding them “highly variable”. HSJ analysis of 50 2009-10 accounts found some trusts had not included substantial quality measures at all, and many had not included benchmarks of past years’ performance or averages, which would have allowed readers to compare (news, 29 July, page 9).

Lord Darzi’s Next Stage Review final report published in 2008 said all providers would publish accounts from April 2010. It said: “These will be reports to the public on the quality of services they provide in every service line - looking at safety, experience and outcomes.”