CQUIN scheme priorities

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.

In 2016/17 a total of £14,300,000 of the trust’s income was conditional upon achieving quality improvement and innovation goals.  Our CQUIN payment framework was agreed with NHS North East London Commissioning Support Unit and NHS England as follows:

CQUIN scheme priorities 2016/2017 Objective rationale
Friends and family test

This national initiative made up of three areas of improvement:

  1. Introduction of health and wellbeing initiatives covering physical activity, mental health and improving access to physiotherapy for people with MSK issues
  2. Healthy food for NHS staff, visitors and patients
  3. Improving the uptake in the flu vaccination for frontline staff
Sepsis

Timely identification and treatment of sepsis in emergency departments and acute inpatient settings

Sepsis is a common and potentially life-threatening condition with around 32,000 deaths in England attributed to sepsis annually.  
Antimicrobial

Reduction in antibiotic consumption across the Trust and a empiric review of antibiotic prescriptions.

Antimicrobial resistance has risen alarmingly over the last forty years and inappropriate plus overuse of antimicrobials is a key driver.

Discharge summaries

Improvement of discharge summaries in A&E and the Medical Admissions Unit.

The Trust has worked closely with Barnet CCG and local GP’s to improve the accuracy and detail in its discharge summaries which is an important driver in providing better patient care and management of long terms conditions as well as reducing readmissions and A&E attendances.

Cancer referrals

Streamlining urgent GP (GMP, GDP or Optometrist) referrals for suspected cancer for the first appointment with a target of two weeks for all cancers

Review of cancer patients waiting longer than 104 days from urgent GP referral to first definitive treatment.

Ensuring efficient investigation, diagnosis and treatment of cancer is essential to ensuring a positive patient experience.

Maternal & child health

To embed a public health approach and implement a maternal and child health programme across the Trust.  Beginning at the first antenatal booking ,through maternal health and paediatric care up to the age of sixteen.  This affords huge potential to support, educate and refer patients early on for a range of health and social risk factors and to help prevent future ill health.

Hepatitis C virus

Supporting the infrastructure, governance and partnership working across healthcare providers working in HCV networks in their second and third years of operation to increase engagement with patients, rollout new clinical and cost effective treatment guidance, improve participation in clinical trials and enhance data collection.

Severe Haemophilia

The HAEMTRACK patient reporting system is an electronic (or paper) patient-reported record of self-managed bleeding and blood product home-therapy usage. This scheme aims to establish the use of the Haemtrack patient home therapy diary as an integral part of clinical care. The scheme offers financial support to all centres to improve recruitment and data quality, and to use Haemtrack as a one of the tools in an increasingly interventionist approach to individual treatment optimisation.

Dose Banding Adult Intravenous SACT

A national incentive to standardise the doses of SACT (Systemic Anticancer Therapy) in all units across England in order to increase safety, to increase efficiency and to support the parity of care across all NHS providers of SACT in England.

Adult critical care timely discharge

To reduce delayed discharges from ACC to ward level care by improving bed management in ward based care, thus removing delays and improving flow.

Telemedicine

To improve patient experience by reducing the number of times a patient is required to attend a face to face outpatient appointment; but instead has their follow-up care and advice conducted through a non-face to face method.

ARV Cost Effective Prescribing

The scheme has identified a number of switches of drug regimen making the best use of available antiretroviral drug regimens that have all been agreed by the clinical and patient leadership of the National HIV CRG Drugs Sub-Group. This approach provides a range of appropriate switches that provide the best approach to ensuring there is opportunity for clinicians to make choices of commissioned treatments which meet the needs of individual patients, whilst being able to maintain an effective overall approach to cost management.

Multisystem Autoimmune Rheumatic Disease

This CQUIN is to support the development of coordinated MDT clinics for patients with multisystem auto-immune rheumatic diseases. This MDT arrangement will also enable longitudinal data collection, particularly of outcome measures using validated tools and the use of patient activation measurement (PAM)

Dental

Collection and submission of data on priority pathways procedures by Tier and to participate in referral management and triage and with active participation in Managed Clinical Networks (MCN)