Quality Premium 2016/17 NHS City and Hackney CCG City of London Health and Wellbeing September 2016
Introduction Quality Premium 2016/17 The ‘Quality Premium’ is set by NHS England and is intended to reward CCGs for • improvements in the quality of the services that they commission and for associated improvements in health outcomes and reductions in inequalities in access and in health outcomes. The full guidance can be accessed here. Where choice was available (see below for which measures have been nationally mandated • and which had some element of choice), the CCG Programme Boards have chosen indicators to support their commissioning plans for the coming year and to align with areas of priority for the CCG. The following slides show the 7 quality premium measures for 2016/17, along with the target • and the money attached if the CCG achieve the target, including: 4 mandatory measures (indicator details set solely by NHS England) – 3 measures where the Programme Boards could choose from the Right Care indicators – where the CCG has identified a potential for improvement. 2
Mandatory Quality Premium Measures (2016/17) Mandatory QP Target CCG Baseline Latest position Programme Board Proposed Actions Relative Absolute Measures Value Value QP1: Cancers Demonstrate a 4% point 51% in 2013 (National Cancer 2015-16 1. Fully explore data and reasons why some 20% £300,000 diagnosed at improvement in the Registry) 54.2% patients are not staged. early stage proportion of cancers Data for 2015 calendar year 2. Focus on 2 highest impact areas – lung and (specific cancer sites, baseline data will be available colorectal cancer. morphologies and behaviour) nationally at the end of 2016. 3. Primary Care Clinical Lead to increase diagnosed at stages 1 and 2 in education of new NICE guidance and raise the 2016 calendar year awareness with GPs on the use of direct compared to the 2015 access to colonoscopy and flexible calendar year. sigmoidoscopy. QP2: More GP March 2017 performance to In December 2015, 38% CAB May-16 Planned Care and Long Term Conditions 20% £300,000 exceed March 2016 utilisation was reported (HSCIC). 38% Programme Boards will review baseline data e-referrals performance by 20 Data for e-referrals baseline will when this becomes available. Input will be percentage points . be based on data in June/July required from other Programme Boards to 2016. achieve this Quality Premium measure. QP3: Overall Demonstrate 3% increase Latest (July 2016) results: July 2016 Primary Care Quality Programme Board 20% £300,000 experience of from July 2016 publication in Good: 73% 73% July 2017 publication on the Poor: 12% Satisfaction with booking an appointment making a GP appointment percentage of respondents (GP Patient Survey) should increase through who said they had a good Results of demand management work with • experience of making an the GP Confederation appointment. Results of workforce work being carried out • under Devolution Part a) reduction in the 0.750 antibacterial items per 12 months to Medicines Management Programme Board 5% £75,000 QP4: Antimicrobial number of antibiotics STAR-PU13 for the latest 12 June 2016 updating the action plan resistance prescribed in primary care. months (year to December 0.728 (AMR) Stay below 1.161 items per 2015). items/STAR-PU improving STAR-PU antibiotic Part b) reduction in the 13.1% year to December 2015. 12 months to Medicines Management Programme Board 5% £75,000 prescribing in proportion of broad spectrum June 2016 updating the action plan primary care antibiotics prescribed in 10.8% primary care to 12% 3
Local Quality Premium Measures (2016/17) Local QP Description Target Latest Position Programme Board Proposed Relative Absolute Measures Actions Value Value QP5: Improve The national review of asthma Reduce the percentage of salbutamol At the end of Q1, the Review patients on 10% £150,000 the quality of deaths (2014) found that 46% of inhalers issued (12 or more in a year) overall position of the salbutamol inhalers and deaths were identified as avoidable to less than 2.5% by Q4 2016/17. rolling data across all reduce number of inhalers care of those with asthma and and that one of the key factors practices was 2.88%, (where clinically safe to do receiving associated with death was excessive Numerator: Number of patients (all which is 0.38 below so) salbutamol prescribing of reliever medication. ages) in primary care issued 12 or more the anticipated target. inhalers salbutamol inhalers in one year However, 22/43 Provide on-going advice and Reduction in the number of patients practice achieved a education to patients about (all ages) in primary care receiving 12 Denominator: number of patients (all position within the the management of their or more salbutamol inhalers per ages) on asthma register. threshold of 2.5% asthma. annum from a baseline of 3.32% in Neaman practice was Q3 2015-16. 1.13% at June 2016 QP6: To increase City and Hackney CCG spends more Reduce the costs of long acting At the end of Q1, Secondary care diabetes 10% £150,000 than similar 10 CCGs on analogue analogue insulins by 10% by Q4 - there was a 24.92% nurse specialists (and the quality of care of those on insulin prescriptions in primary care. 2016/17. We will expect a reduction in increase in costs of consultant lead) who work in insulin and This is an opportunity to work cost of £155K analogue insulin primary care to work reduce the costs collaboratively with the secondary [baseline Q4 2015/16 data calculated prescribing. collaboratively to implement of long acting care services and staff who deliver using Apr 15-Feb15 data] to £140K for Neaman practice was changes that will increase the services in primary care. Q4 (2016/17) the only practice to quality of interventions, analogue insulin. score a reduction of patient reviews, and reduce Numerator: Number of patients (17+) cost across City and unwarranted spend. with analogue prescriptions Hackney (-11.93% from baseline) Denominator: Number of patients (17+) on diabetes register QP7: To increase 2014/15 figures show that there is Increase prevalence by 0.3% (800) cases Data for 2016/17 will Working with the GP 10% £150,000 the number of currently a 6.6% (15,113 actual by April 2017 be available in Confederation on coding and patients cases) prevalence of depression GP October 2017 accurate depression registers recorded on GP registers in City and Hackney CCG. Note: the percentage is small as we are This was highlighted as an area for working with large numbers Reviews using a bespoke registers identified with local interpretation in the Right Care EMIS template. depression Commissioning for Value data pack. Numerator: number of patients (depression It is an area known to be under- identified as having depression. prevalence) reported. Denominator: City and Hackney GP across the CCG register (300,197 – September 2015) 4
Constitution Requirements (2016/17) Quality Premium – Payment Restrictions The quality premium will be reduced if the CCG does not meet the NHS constitution requirements for the following patients rights or pledges from the services that it commissions NHS Constitution Target 2015/16 CCG Baseline Adjustment to Requirement funding 25% Referral to treatment 92% of patients on incomplete non-emergency 94.65% times (18 weeks pathways (yet to start treatment) should have been incomplete) waiting no more than 18 weeks from referral. Q4 2016/17 performance will be assessed for the QP. 25% A&E waits – All types 95% of patients should be admitted, transferred or 93.92% discharged within 4 hours of arriving at A&E. Q4 2016/17 performance will be assessed for the QP. 25% Cancer Waits – 62 days 85% of patients should wait a maximum of 2 months (62 84.20% days) from urgent GP referral to first definitive treatment for cancer. 25% Category A Red 1 75% of Red 1 ambulance calls result in an emergency 68.11% ambulance calls response arriving within 8 minutes. Source: NELCSU (Unify2) 5
Recommend
More recommend
