Clinical commissioning groups will be able to choose some of their own targets for the “quality premium” pay for performance scheme, the NHS Commissioning Board’s first planning guidance reveals.
However, they could be barred from receiving the payment at all if they have a significant quality failure or overspend their budget during the year. Payment will also be dependent on achieving the rights and pledges in the NHS constitution, including waiting times.
To receive the quality premium payment in 2014-15 all CCGs will have to see improvement against four nationally set measures from the NHS Outcomes Framework during 2013-14, and against three locally identified measures agreed with the commissioning board.
The funds - which could be worth up to £5 per head of population - will be paid to CCGs. It is likely CCGs will then decide how to use them, including the possibility of paying them to member GP practices.
The four mandatory measures are:
- potential years of life lost from causes considered amenable to healthcare;
- avoidable emergency admissions
- the Friends and Family Test; and
- Incidence of healthcare associated infections (MRSA and Clostridium difficile).
The guidance says the three locally agreed measures should be chosen after discussion with health and wellbeing boards and other stakeholders, “especially” patients and local community representatives.
The improvement needed against each of the measures in order to trigger the payment should be “expressly” agreed between the CCG and the commissioning board’s local area team.
The guidance describes 2013-14 as a “test bed” year to understand how an outcomes-based commissioning system will work in practice. It does not set national targets for CCG performance but instead expect CCGs and local area teams to prioritise and make improvements in areas where there is the greatest need.
The guidance also reveals during the year the commissioning board will “oversee a fundamental review of the incentives, rewards and sanctions available to commissioners” to inform the 2014-15 planning round.
Full coverage: Commissioning board sets priorities and rules for 2013-14
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CCGs will choose own improvement areas for quality payment