The Commissioning for Quality and Innovation (CQUIN) payment framework enables commissioners to reward excellence by linking a proportion of English healthcare providers' income to the achievement of local quality improvement goals. Since the first CQUIN framework in 2009/10, many CQUIN schemes have been developed and agreed. For 2014/15 this framework was expanded at the Royal Free Hospital following the acquisition to incorporate Barnet and Chase Farm hospitals.
|CQUIN scheme priorities 2014/2015||Objective rationale|
|Friends and family test||This national initiative will provide timely, detailed feedback from patients about their experience in order to improve services for the user. There is significant room for improving the level of feedback received from patients across England.|
|Dementia||A quarter of beds in the NHS are occupied by people with dementia. Their length of stay is longer than people without dementia and they often receive suboptimal care. Half of those admitted have never been diagnosed before admission and referral to appropriate specialist community services is often poor. Improvement in assessment and referral will give significant improvements in the quality of care and substantial savings.|
|NHS safety thermometer||Participation in data collection is an important step in reducing harm in four areas of concern highlighted nationally. A particular focus is on reducing incidents of pressure ulcers in hospital and the local community.|
|Prevention: stop cessation, alcohol screening and domestic violence||Helping patients to stop smoking is among the most effective and cost effective of all interventions the NHS can offer patients. Simple advice from a clinician during routine patient contact can have a small but significant effect on smoking cessation.
Alcohol related problems represent a significant share of potentially preventable attendances to accident and emergency departments and urgent care centres, as well as emergency admissions. Screening for alcohol risk has been shown to reduce subsequent attendances and alcohol consumption.
Finally, to introduce and develop existing measures that will help identify, assess and advise patients where there is evidence of domestic violence.
|Integrated care||There are a significant number of frail older people admitted to hospital. Identification and assessment of these patients, sharing information with GPs and participating in multidisciplinary meetings help to improve care and reduce the cost of treating these patients.|
|Value based commissioning||The hospital acknowledges that a radical long term change in managing patient care is required to ensure that there will be sufficient resources to meet future demands locally for healthcare. This CQUIN is based upon the service transformation programme regarding development of the redesigned patient pathways.|
|Admission avoidance for frail elderly||To reduce the number of unnecessary emergency admissions to ensure only patients who actually require admission are admitted and to provide ambulatory or same day care as an alternative to admission for elderly patients.|
|Making every contact count: quality of discharge information to primary care||The hospital will ensure that discharge documentation sent to primary care following a patient’s admission effectively details all relevant data and clinical information obtained and recorded during the patient’s stay in hospital with a specific focus on patients with chronic conditions.|
|Making every contact count: increasing the stop smoking offer for patients in contact with health services||Introducing an implementation plan specifically across Barnet and Chase Farm hospitals to improve the recording of smoking status and increase the access to effective support and treatment to stop smoking.|
|Workforce||The hospital will work to ensure that their workforce has the capacity and capability to deliver compassionate and safe care. This is in support of the publication by NHS England of “How to ensure the right people, with the right skills, are in the right place at the right time.”|
|National quality dashboard||Implement clinical dashboards for specialised services. The dashboards provide information on outcomes for specialised services and assurance on the quality of care.|
|Highly specialised services||For amyloidosis, lysosomal storage disorders, liver transplant and islet transplant services participate in an annual workshop to encourage learning and the spread of best practice.|
|Endocrinology||Identify specialised endocrinology activity in our out-patient departments.|
|Haemodialysis||To encourage patient involvement in elements of the tasks of in-centre and satellite haemodialysis.|
|HIV telemedicine||Introduce telemedicine care for clinically appropriate patients diagnosed with HIV.|
|Patient and public engagement||Improve patient and public engagement within the trust. Areas targeted in 2014/15 include renal and liver transplantation, pulmonary hypertension and cancer services.|
|Vascular service transformation||Improve patient experience by developing service transformation in vascular services resulting in admission avoidance.|
|AAA screening||Increase the uptake rates for abdominal aortic aneurysm screening.|
|NICU||To achieve an increase in retinopathy of prematurity screening for babies while still an in-patient.|
|Breast screening||Increase the uptake rates for breast screening.|
|Dental||Complete the dental dashboard. The dashboard provides information on outcomes for dental services and assurance on the quality of care.|