Health Bill [HL]

The amendments laid by the noble Earl, Lord Howe, and the noble Baroness, Lady Cumberlege, would require that duties in the Bill to publish quality accounts include publication on a website and set out defined routes for discharging these duties. As I said earlier, the Bill requires providers to submit a copy of their quality accounts to the Department of Health for the explicit purpose of making the quality accounts available to the public. I reassure the noble Earl that this is the method through which information from the quality accounts will end up on the NHS Choices website. The website is the ideal place, because it will provide that comparative information from all providers at the local level, the regional level and even at the national level. Subsections (6) and (7) of Clause 7 already make provisions to provide information on the manner in which patients and the public may access a copy of the quality account. However, we are also discussing with trusts, patient groups and regulators what else we can do besides publishing the information on the NHS Choices website and how we can ensure the effective public availability of quality accounts without overburdening the NHS. Our guidance will set out how this is to be achieved. It will, I hope, be reasonable and appropriate, which is exactly what the noble Earl, Lord Howe, wishes to see and, I think, seeks to achieve in Amendments 39 and 42. Amendment 41, which has been laid by the noble Earl, would impose on NICE a role in helping people to understand providers’ quality accounts. Again, I appreciate his desire to see comparability between quality accounts, but I do not believe that NICE is best placed to do this. We put a lot of thought into this and consulted on it when we published High Quality Care for All. NICE has done a wonderful job in setting standards and in looking at the evidence base and making it available. I felt at the time that the best way of providing this comparative information was to work through the quality observatories at the regional level and at the national level through the National Quality Board, on which NICE, the CQC and Monitor are represented. In that way we can develop the systems and tools by which we will make that information much more comparable and digestible from a user’s perspective. I refer again to what is in the quality accounts. I think I have said before that they will include some of the indicators that are part of the operating framework. MRSA infections were one such indicator. That will be there, and there will certainly be comparable data for the indicator, as measured nationally. The CQC’s data on safety and quality and measuring compliance against their registration requirement will also be available and will be comparable. There are numerous examples, one of which might be how providers are ensuring that any patients who need help with eating and drinking receive it and whether providers are ordering, handling, storing, administering and disposing of medicine safely. The example I should like to bring in now, which is much more relevant to what the noble Earl said, is the role of NICE. One indicator within quality improvement will be the percentage of patients admitted with heart attacks who, on discharge, are prescribed an anti-platelet agent or a statin. NICE has the evidence base. In setting that, we need an assured indicator on which we can measure whether a provider publishes that in its accounts. We will encourage that. This is exactly the type of quality improvement measure that could be part of the quality accounts. I hope I have clarified that it is our intention to get this information as widely, as accurately and as comparable as possible. Ultimately, we are trying to empower patients with the information that they need to make those choices.