Commissioners will be told to be more ambitious and avoid duplication when setting their commissioning for quality and innovation (CQUIN) framework goals for next year.

Guidance on the CQUIN framework will be included in the 2010-11 NHS operating framework, with the percentage of the tariff contingent on CQUIN expected to rise from 0.5 per cent to 1.5 per cent next year.

Lining it up so each provider is delivering their bit to make the overall work - as Coventry and Warwickshire did - we would strongly encourage that

Department of Health CQUIN framework policy lead Flora Swanborough last week set out the “future direction of travel” for the framework.

Speaking at a Primary Care Trust Network commissioning conference in London, she said there would be a “stronger message on ambition and real quality improvement” in the new framework, with PCTs encouraged to avoid duplicating basic contractual requirements in CQUIN schemes.

She added that the aim was to have one scheme per provider and it was therefore important for commissioners to work together to achieve this, for example along clinical pathways.

One current CQUIN scheme in Coventry and Warwickshire has been used to drive the development and implementation of a dementia pathway across acute, community and mental health providers.

Ms Swanborough said: “We would strongly encourage CQUIN to bring about change in pathways.

“You’ve got to be careful what you actually reward an individual provider for but, as Coventry and Warwickshire did, lining it up so each provider is delivering their bit to make the overall work – we would strongly encourage that,” she said.

She also told delegates that the 10 specialised commissioning groups should be developing their own CQUIN schemes for the services they commissioned.

“They should agree separate CQUIN schemes in relation to those services – partly because it’s large amounts of money, partly because it just fits with the overall contract and commissioning relationship there,” she said.

“The specialised commissioning groups are quite keen to develop a hit list of indicators for specialised services that they’ll be using across the country,” she said.

But Ms Swanborough added that the DH was keen to encourage close co-operation between the specialised commissioning groups and their PCTs so that targets were not duplicated.

She also said the DH would in future provide a “standard format” for CQUIN schemes in contracts with worked examples. This information would be available from the “PCT Portal” on the NHS Institute website. Commissioners would also be encouraged to share their schemes via the portal.