The government has recently undertaken an evaluation of the 2009/10 quality accounts and set out their expectations for 2010/11.
The King's Fund undertook an independent analysis of a sample of quality accounts produced by a range of providers – acute trusts, mental health trusts, independent providers. The analysis focused on three particular aspects of the quality accounts:
- the choice of quality measures used to review performance, their reliability and presentation
- the quality of the data and how far providers have participated in national clinical audits and confidential enquiries
- how providers have reported patient and public feedback and involvement of local stakeholders and what external comments have focused on.
This paper includes examples from 2009/10 quality accounts that show how the content and the presentation of information can vary. Based on these examples, we make recommendations for providers when they are developing and writing a quality account.
We also have recommendations for policymakers for future guidance on quality accounts; on data quality; on clinical audits and confidential enquiries; and on external scrutiny.
We conclude that, fundamentally, quality accounts are so varied because they are having to provide commentary on a wide range of services, are serving a broad range of audiences and are also attempting to meet two related, but different, goals of local quality improvement and public accountability. The future for public accountability needs to focus more on the centralised provision of standard, consistent and comparable measures, published in forms that enable interpretation and comparison. Individual quality accounts can then both draw on these measures and select local priorities and measures, as long as those measures can be given with benchmark or trend information to provide some context for interpretation.