The requirement for providers of NHS services in England to produce annual Quality Accounts for the public was one component of the Next Stage Review in 2008. Introduced in 2010, apart from aiming to improve the public accountability of providers, it is anticipated that the Quality Accounts will prompt boards to engage more in considering quality, and encourage quality assessment and improvement among clinicians and managers. Our aim was to appraise one section of Quality Accounts, the reporting of national clinical audits (NCAs). A review of a random sample of 50 acute Trusts revealed that for the 94% of Trusts that provided an account of their participation in the 34 NCAs deemed eligible by the Department of Health, the overall participation rate was 69%. Rates varied between Trusts, from less than 40% to 100%. Although most Trusts did not provide examples of local quality improvement, interventions stimulated by NCAs, those that did demonstrated some innovative and effective ways of improving quality. We propose several ways in which the quality of Quality Accounts can be improved in 2011.