Improving care for circulatory diseases and reducing emergency admissions are the targets most commonly chosen by clinical commissioning groups to be linked to their income, research has found.

Communications consultancy MHP Health analysed the indicators 30 CCGs have chosen to be measured on under the quality premium pay for performance scheme.

CCGs’ are due to receive additional income based on their performance against several nationally set indicators, and three chosen locally.

MHP analysed those chosen locally. They found, however, that many of these were based on established national priorities and outcome indicators.

Those most commonly selected covered circulatory conditions - stroke and cardiovascular disease - reducing emergency admissions; mental health; diabetes; and dementia.

The organisation said it had found areas of care where few nationally endorsed measures existed – such as neurological and musculoskeletal conditions, or learning disabilities – were not commonly selected as priorities.

Only one in 10 indicators was explicitly focused on integration.

MHP account director Richard Sloggett said: “This research demonstrates the importance of securing indicators and incentives at a national level to drive local service change.  It is not surprising that commissioners are aligning local quality payments with national measures which they will be assessed against, such as reducing emergency admissions. 

“However, [the work also] raises challenges for those looking to improve care on the ground for those in under-prioritised areas of care, such as musculoskeletal and neurological conditions.

He warned against the risk of a “further drive to a two-tier system of quality depending on a patient’s particular condition and location”.

Under the 2012 Health Act and government guidance, each CCG is eligible to receive £5 per patient of its population under the quality premium. They can earn up to 37.5 per cent of the premium against local indicators, although CCGs will get nothing if they fail to meet key performance requirements.

NHS England has yet to clarify the process for allocating the funds, or if it will provide further guidance on how the money can be used. Currently it is expected to be spent on patient care, but it is unclear whether it will be able to be passed to GP practices.

MHP analysed the 30 CCGs that were in the first “wave” of the authorisation process and had made their priorities available.

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