Health Bill [HL]

Amendments 38 and 49, tabled by the noble Earl, Lord Howe, discuss the role of the Care Quality Commission. I will consider each amendment in turn. Amendment 38 gives a formal role to the Care Quality Commission in auditing each organisation’s quality accounts. I share the desire of the noble Earl that quality accounts should be accurate; otherwise they would be meaningless. The most effective way in which we can achieve that is by working with provider organisations to develop assured indicators in the first place. That is where we are at the moment. We must ensure that we have an assured indicator across the system. We believe we have the tools to measure that. Our regulations and guidance will then set out options for producing a meaningful set of quality accounts. Providers will be required in regulations to confirm that the content of their quality account represents a trustworthy and reliable view of the services they offer. There will be no requirement for the quality accounts to be formally audited, as the noble Earl pointed out, but we wish to encourage providers to seek external validation on a voluntary basis, perhaps from their local PCT, local involvement network or even the local authority. This is not a novel approach; anyone who has ever filled in a tax form will have come across it. Quality accounts are, however, not about the heavy hand of regulation but about adding to the drive for quality improvement. The Bill provides that a provider must change its quality account if any errors are brought to its attention by the Care Quality Commission—part of the quality account is the indicators that the Care Quality Commission measures—its local SHA or Monitor, if it is one of the tier 1 indicators on the operating framework. So the data are already reported to the regulators and commissioners, and there is simply no need for an additional audit of that component of the data. On the other component, which is mostly about the indicators for quality improvement, most professional bodies and a lot of national audits that are currently in the system have an assurance framework to ensure that the data collected is accurate. I turn to the role of the regulator. I certainly agree with the noble Baroness that it should not spend its limited resources on this quality assurance exercise but should channel its energy mostly into acting on what the data says. Any significant quality issues should already be clear to the CQC through the registration process and should merely be reflected in the quality account. Should any significant new issues be raised through a quality account, the CQC has powers to investigate. Data being collected centrally is only a part of what quality accounts are to achieve. Our vision for quality accounts is to encourage the culture of measurements with the purpose of quality improvement. I do not believe that that should be a centralised performance management issue, but mostly about empowering clinicians, with the information that they collect, and helping them with quality improvements.