1.2.4 Incentives in the system Flashcards
What provides national level accountability for the outcomes the NHS delivers; driving transparency, quality improvement and outcome measurement throughout the NHS. It also sets out the National outcome goals that the Secretary of State uses to monitor the progress of NHS England.
The NHS Outcomes Framework.
Indicators in the NHS Outcomes Framework are grouped into 5 domains, which set out the high level national outcomes that the NHS should be aiming to improve - for each domain, there are a small number of overarching indicators followed by a number of improvement areas. What are these domains?
Domain 1: Preventing people from dying prematurely.
Domain 2: Enhancing quality of life for people with long-term conditions.
Domain 3: Helping people recover from episodes of ill health of following injury.
Domain 4: Ensuring that people have a positive experience of care.
Domain 5: Treating for people in a safe environment and protecting them from avoidable harm.
What is part of the General Medical Services (GMS) contract for general practices and was introduced on 1st April 2004?
The Quality and Outcomes Framework (QOF)
What does QOF reward?
The QOF rewards practices for the provision of quality care and helps fund further improvements in the delivery of clinical care.
QOF is based on a points system and payments are calculated according to the practice list size. how many points are there across two domains for clinical and public health indicators and what is the value of QOF points for 2019/20?
There are 559 points across two domains for clinical and public health and the value of QOF point for 19/20 is £187.74
What is QOF the incentive for?
a. Primary Care Practices
b. Providers
c. CCGs
a. Primary Care Practices.
What is the incentive for Providers?
CQUINs = commissioning for Quality and Innovation payments.
What system was introduced in 2009 to make a proportion of healthcare providers income conditional on demonstrating improvements in quality and innovation in specified areas of care?
CQUINs
Therefore a proportion of the providers income depends on achieving quality improvement and innovation goals agreed between the Trust and its commissioners.
What is the sum attached to the CQUINs each year? and based on?
The sun attached to the CQUINs is variable each year based on a percentage of the contract value and depends on achieving quality improvement and goals.
The 2019/20 CQUIN scheme comprise indicators aligned to 4 key areas in support of the Long Term Plan, what are these?
- Prevention of Ill Health
- Mental Health
- Patient Safety
- Best Practice Pathways.
National indicators must be used where relevant, however, where insufficient national indicators are available, CCGs should offer local CQUIN indicators - What is the total value of indicators equal to?
The total value of indicators should be equal to 1.25% of the contract value.
What are the national indicators for acute healthcare?
- Staff flu vaccinations.
- Alcohol and Tobacco Brief Advice.
- Three High Impact Actions to Prevent Hospital Falls.
- Antimicrobial resistance - Urinary Tract Infections and Antibiotic Prophylaxis for Elective Colorectal Surgery.
- Same Day Emergency Care - Pulmonary Embolus/Tachycardia with Atrial Fibrillation/ Pneumonia.
What are the national indicators for Community healthcare?
- Staff Flu Vaccinations
- Alcohol and Tobacco Brief Advice
- Three High Impact Actions to Prevent Hospital Falls.
- PICC Lines Secured Using a SecurAcath Device.
- Stroke 6 Month Reviews.
What are the national indicators for Mental Health?
- Staff Flu Vaccinations
- Alcohol and Tobacco Brief Advice.
- 72 hr Follow up post discharge
- Improved Data Quality and reporting
- Use of anxiety Disorder Specific measured in IAPT
What are the National indicators for Ambulances?
- Staff Flu Vaccinations (0.25%)
- Access to Patient Information - Assurance Process (0.5%)
- Access to Patient Information - Demonstration (0.25%)
- Locally Determined Indicators (0.25%).
