NHS trust boards must have continuous focus on improving quality of care

For the pursuit of quality to become embedded within the NHS there needs to be a continuous focus on it by the management and board of every health service organisation and a personal commitment to it from their chief executives.

That is one of the key messages from The King's Fund's response to a joint consultation on quality accounts led by Monitor, NHS East of England, the Care Quality Commission (CQC) and the Department of Health. New reporting requirements announced today mean that all foundation trusts in England and all NHS organisations in the East of England will report on the quality of care they deliver, as well as how they plan to improve it, as part of their 2008–09 annual reports.

The NHS Next Stage Review proposed the introduction of quality accounts as a tool for publicly recording and monitoring the quality of care being offered to patients around the country. The new accounts will be brought into law by the Health Bill which is currently going through Parliament.

Explaining The King's Fund's submission to the consultation, Dr Anna Dixon, Director of Policy, said:

'As the revelations about care at Mid-Staffordshire foundation trust made clear, if the health service does not make quality a priority, the consequences for patients can be catastrophic. We support the objectives of quality accounts and applaud NHS East of England for its leadership. However, there are a number of issues that need further development in order to ensure that the new accounts really ensure a focus on quality is embedded in the day to day running of the NHS and are not seen as a once a year ‘box ticking’ exercise.

'There needs to be a continuous focus on quality by the board and a personal commitment to it from the chief executive. More than just making an annual statement, boards should receive monthly dashboards that track quality throughout the year in the same way as financial information is monitored and reported. Without this, quality reporting could be an annual exercise that fails to take hold in the organisation.

'Furthermore, if quality accounts are to be a trustworthy, transparent and meaningful source of information on the quality of NHS care some form of external audit or scrutiny of them is essential. The current proposals do not do enough to encourage, or require, a full and frank accounting of quality.

'And in order for quality accounts to help the public judge whether their local health services are up to scratch the information needs to be presented in a way that is easy to read and understand and that can be compared with national averages.

'If they are rigorous, quality accounts have the potential to help create a new era in which local NHS services are systematically held to account not just for balancing the books but for the quality of care they provide.'

Notes to editors: 

  1. For further information or interviews, please contact The King’s Fund press and public affairs office on 020 7307 2585, 020 7307 2632 or 020 7307 2581. An ISDN line is available for interviews on 020 7637 0185.
  2. The King’s Fund is a charity that seeks to understand how the health system in England can be improved. Using that insight, we help to shape policy, transform services and bring about behaviour change. Our work includes research, analysis, leadership development and service improvement. We also offer a wide range of resources to help everyone working in health to share knowledge, learning and ideas.